Social Security Disability Eligibility Requirements

Disability eligibility

According to the Social Security Administration (SSA), 56 million Americans, or one-in-five live with disabilities, with 38 million Americans, one-in-ten living with severe disabilities. In addition, more than one-in-four 20-year olds today will become disabled before reaching retirement age. Living with a disability may substantially impact a person’s ability to earn enough money to support themselves and their family. If you are currently disabled and unable to work or your work capacity is severely limited, you may be eligible for Social Security disability benefits.

The SSA pays disability benefits through two programs: the Social Security disability insurance (SSDI) and the Supplemental Security Income (SSI). Both programs supplement the income of individuals who are unable to work due to a medical disability. While medical eligibility for disability is determined in the same manner for both programs, the two programs are different and serve two distinct populations, with different financial eligibility requirements. To learn more about SSDI and SSI benefits, click here. In this post, we will outline the eligibility requirements for SSDI and SSI.

Who can get disability benefits under Social Security?

There are three categories of individuals who can qualify for benefits on the basis of disability:

A disabled insured worker under full retirement age
An individual disabled since childhood (before age 22) who is a dependent of a parent entitled to title II disability or retirement benefits, or was a dependent of a deceased insured parent
A disabled widow or widower, age 50-60 if the deceased spouse was insured under Social Security

Eligibility Requirements

Meeting the eligibility requirements for disability and getting your application approved is no easy task. In fact, 70% of all initial applications for Social Security disability benefits are rejected. To increase your chances of approval, you should become familiar with the eligibility requirements, as well as gather the correct information and documentation about your medical disability and employment history. To guide you through the eligibility requirements, we are going to give you a summary of the requirements, then dive deep into the details:

To be eligible for Social Security Disability Insurance (SSDI):

You must have worked and paid Social Security taxes for a sufficient period of time to be covered under Social Security insurance. You must also meet all of the following requirements:

Be the insured worker or the worker's adult child or widow(er)
Meet SSA’s medical disability criteria
Not be performing any substantial work as defined by SSA

To be eligible for Supplemental Security Income (SSI) based on a medical condition:

You must have meet all of the following requirements:

Have little or no income or resources
Be a US citizen or meet the requirements for non-citizens
Meet SSA’s medical disability criteria
Not be performing any substantial work as defined by SSA.

Detailed Eligibility Requirements

Here is a detailed look at the eligibility requirements for SSDI and SSI application. There are two parts to the requirements - the medical eligibility and non-medical eligibility qualification:

Medical Eligibility Requirements for SSDI & SSI

To qualify for SSDI or SSI disability benefits, you have to be totally disabled. The Social Security Administration (SSA) does not pay benefits for partial disability or for short-term disability.

SSA Definition of Disability

Definition for Adults--

If you are an adult and want to file for Social Security Disability, your condition must meet the following criteria for you to be considered disabled:

You cannot do work that you did before
It is determined that you cannot adjust to other work because of your medical condition(s)
Your disability has lasted or is expected to last for at least one year or result in death

Definition for Children--

The child must have a physical or mental condition(s) that very seriously limits his or her activities
The condition(s) must have lasted, or be expected to last, at least 1 year or result in death

How The SSA Reviews Your Medical Eligibility

The SSA maintains a listing of eligible medical conditions in what is called the Blue Book. These medical conditions, also known as “Listing of Impairments,” are severe enough to prevent an individual from doing any gainful activity (or in the case of a child under age 18 applying for SSI, severe enough to cause marked and severe functional limitations). You are likely to be awarded disability benefits if you have medical evidence of one of these conditions. However, in most cases, the Social Security Administration does not award benefits based solely on the name of the diagnosis, disease or condition you have. If your disability is not listed in the Blue Book, there are other ways to show you have a medical impairment that prevents you from working. In addition, if you have multiple disabilities or medical conditions, the SSA will consider the combined effects of all illnesses and injuries when making their determination regarding medical eligibility for disability. For the complete Listing of Impairments, click here.

How the Disability Determination is Made

The Social Security Administration uses a procedure known as the "sequential evaluation process" for making a determination about a person’s disability. For adults, this is a five-step process that requires a sequential review of the following:

Claimant's current work activity (if any)
Severity of his or her impairment(s)
Determination of whether his or her impairment(s) meets or medically equals a listing (see Part III of this guide)
Claimant's ability to perform his or her past relevant work
Claimant's ability to do other work based on age, education, and work experience

For children applying for SSI, the process requires a sequential review of the following:

Child's current work activity (if any)
Severity of his or her impairment(s)
Assessment of whether his or her impairment(s) meets, medically equals, or functionally equals a listing

If SSA can find an adult or child disabled or not disabled at any step, the evaluation is complete.

Non-Medical Requirements for SSDI

In addition to meeting the medical requirements, the other part of SSDI eligibility is to make sure you have accumulated the appropriate number of work credits. Social Security work credits are based on your total yearly wages or self-employment income. You can earn up to four credits each year. The number of work credits you need to qualify for disability benefits depends on the age in which you become disabled. Unless you are blind, if you are disabled at age 31 or older, you generally need at least 20 credits in the 10 years immediately before you became disabled. If you are a younger worker, may qualify with fewer credits.

The table below shows you how many credits you need depending on the age at which you became disabled, and the years of work required to have earned those number of credits:

Disabled at Age	Credits Needed	Years of Work
Under 24	6	1½
24-30	8-18	2-4½
31-42	20	5
44	22	5½
46	24	6.0
48	26	6½
50	28	7.0
52	30	7½
54	32	8.0
56	34	8½
58	36	9.0
60	38	9½
62 or older	40	10

The quickest way to check if you have earned enough credit to qualify for Social Security Disability is to log into your my Social Security account and review your Social Security Statement. Once you are logged in to your account, download your latest Social Security Statement and review “Your Estimated Benefits” section to see whether you’ve earned enough credits. If you do not have a my Social Security account, click here to learn more about how to sign up for an account.

Non-Medical Requirements for SSI

In addition to meeting the medical eligibility requirements (outlined above) to be approved for Supplemental Security Income, you must also meet the following income and resource requirements:

Income Requirements

The income limit for SSI is set at the 2018 Federal Benefit Rate (FBR) of $750 per month for an individual and $1,125 per month for a couple.

What Income Counts Towards the Limit?

Earned Income - wages, net earnings from self–employment, certain royalties, honoraria, and sheltered workshop payments

Unearned Income - all income that is not earned, such as Social Security benefits, pensions, state disability payments, unemployment benefits, interest income, and cash from friends and relatives

In–Kind Income - food or shelter that you get for free or less than its fair market value

Deemed Income - part of the income of your spouse with whom you live, your parent(s) with whom you live, or your sponsor (if you are an alien)

What Income Does Not Count?

The first $20 of most income received in a month
The first $65 of earnings and one–half of earnings over $65 received in a month
The value of Supplemental Nutrition Assistance Program (food stamps) received
Income tax refunds
Home energy assistance
Assistance based on need funded by a State or local government, or an Indian tribe
Small amounts of income received irregularly or infrequently
Interest or dividends earned on countable resources or resources excluded under other Federal laws
Grants, scholarships, fellowships or gifts used for tuition and educational expenses
Food or shelter based on need provided by nonprofit agencies
Loans to you (cash or in–kind) that you have to repay
Money someone else spends to pay your expenses for items other than food or shelter (for example, someone pays your telephone or medical bills)
Income set aside under a Plan to Achieve Self–Support (PASS)
Earnings up to $1,790 per month to a maximum of $7,200 per year
The cost of impairment–related work expenses for items or services that a disabled person needs in order to work (i.e. transportation)
The cost of work expenses that a blind person incurs in order to work
Disaster assistance
The first $2,000 of compensation received per calendar year for participating in certain clinical trials
Refundable Federal and advanced tax credits received on or after January 1, 2010
Certain exclusions on Indian trust fund payments paid to American Indians who are members of a federally recognized tribe

Resource Requirement

The limit for countable resources is $2,000 for an individual and $3,000 for a couple in 2018.

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What Resources Count Towards the Limit?

Resources are things you own such as following items:

Cash
Bank accounts, stocks and U.S. savings bonds
Land
Life insurance
Personal property
Vehicles
Anything else you own which could be changed to cash and used for food or shelter
Deemed resources

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What Resources Do Not Count?

The home you live in and the land it is on
Household goods and personal effects (e.g., your wedding and engagement rings)
Burial spaces for you or your immediate family
Burial funds for you and your spouse, each valued at $1,500 or less
Life insurance policies with a combined face value of $1,500 or less
One vehicle, regardless of value, if it is used for transportation for you or a member of your household
Retroactive SSI or Social Security benefits for up to nine months after you receive them (including payments received in installments)
Grants, scholarships, fellowships, or gifts set aside to pay educational expenses for 9 months after receipt
Up to $100,000 of funds in an Achieving a Better Life Experience (ABLE) account established through a State ABLE program
Property essential to self–support
Resources that a blind or disabled person needs for an approved plan for achieving self–support (PASS)
Money saved in an Individual Development Account (IDA)
Support and maintenance assistance and home energy assistance that we do not count as income
Cash received for medical or social services that we do not count as income is not a resource for one month (exception: Cash reimbursements of expenses already paid for by the person are evaluated under the regular income and resources rules.)
Health flexible spending arrangements (FSAs)
State or local relocation assistance payments - not counted for 12 months
Crime victim assistance - not counted for 9 months
Earned income tax credit payments - not counted for 9 months
Dedicated accounts for disabled or blind children
Disaster relief assistance which we do not count as income
Cash received for the purpose of replacing an excluded resource (for example, a house) that is lost, damaged, or stolen is not counter for 9 months
All Federal tax refunds and advanced tax credits received on or after January 1, 2010 are not counted for 12 months
The first $2,000 of compensation received per calendar year for participating in certain clinical trials
Some trusts