How Does the Social Security Administration Determine Disability?

SSA Determines Disability Based On Medical Evidence

There are two types of disability claims:

One is for individuals who have been disabled since June 1, 1980. This type of claim is called an old age insurance claim. The other type of disability claim is called a disability insurance claim. This is when someone files a claim to get disability benefits because of an accident, illness, or injury that occurred on or after January 1, 1954.

The old age claim is handled by the SSA and the disability claim is handled by the Social Security Administration Office of Disability Operations. If you file a disability claim, you will be asked to prove that you have a severe physical or mental impairment, that this impairment prevents you from doing any substantial gainful activity, and that this impairment will last at least 12 months.

If you are able to prove that you are disabled, the SSA will pay you a monthly benefit for the rest of your life. There are a number of ways that you can prove that you are disabled.

If you are applying for old age benefits, the SSA will ask you to see a doctor and give him or her a copy of your medical records. This is called an examination report.

In some cases, the SSA will examine you. This is called a consultative exam. The SSA may order a consultative exam if there is reason to believe that you do not have enough medical evidence to make a decision.

In addition, the SSA may ask your doctor to write a report that is included in your record. This is called a medical source statement. The SSA will also review your doctors notes and medical tests to determine if your condition meets the definition of disability.

If you are not eligible for old age disability benefits, you will be asked to provide information to the SSA that proves that you are unable to work because of a physical or mental condition. The information that you provide will help the SSA decide whether you are disabled.

You may be able to get benefits under both old age and disability programs. The SSA pays benefits to the person who has the greatest financial need. This is determined by comparing the value of the benefits that are being paid to all eligible people.

The SSA will usually pay benefits to a disabled person for as long as he or she needs the benefits. You cannot get benefits if you are able to work. You cannot get benefits before the date that you meet the requirements for old age disability.

When Do People Start Receiving Social Security Disability Insurance Benefits?

Social Security Disability Insurance (SSDI) is an income replacement benefit program administered by the U.S. Department of Health and Human Services (HHS), under Title II of the Social Security Act. The SSDI program is designed to help disabled individuals maintain a minimal standard of living.

The SSDI program provides monthly benefits to eligible workers who become disabled and meet certain requirements. The Social Security Administration (SSA) issues a check to SSDI beneficiaries every month, based on their earnings record. The total amount of benefits is capped at $2,000 per month.

There are two primary requirements for SSDI eligibility. First, the applicant must be at least 18 years old and have earned enough money in his or her work history. Second, the applicant must be unable to work because of a medical condition or disability.

A disability exists when a person cannot perform the regular duties of a job on account of a physical or mental impairment. This can include a specific impairment, such as arthritis, or it can be a general inability to perform any kind of work.

To qualify for SSDI, the applicant must apply at least 60 days before the onset of the disabling condition. The onset date is the first day of the month the disability is diagnosed. The application process requires the applicant to prove that he or she is disabled and incapable of working.

In addition to the initial application, the claimant must submit periodic proof of continuing disability to maintain eligibility. The SSA usually requires that SSDI recipients submit periodic medical statements. These statements are reviewed every four years to ensure the disability continues.

To collect the benefits, applicants must meet the following criteria:

• They must have worked long enough to earn an average of at least $1,400 a month.

• Their disability must prevent them from performing their previous work.

• The disability must result from a medically determinable impairment.

• The applicant must be unable to engage in any substantial gainful activity.

• The disability must have existed for at least 12 months, and cannot be considered temporary.

• The disability must be expected to last, or has lasted, for at least 12 months.

The SSDI application can be completed online, and a claimant is entitled to an attorney if needed. The claim process is a relatively simple and straightforward one, though the process can take as long as two years to complete.

For more information about SSDI, visit www.ssa.gov/disability or call the SSA at 800-772-1213.