Are You Disabled?

If Social Security says that you have worked enough to be insured, then they will decide whether they consider you disabled.

To figure out whether you are disabled, Social Security will look at your SSDI application and all additional material you supplied and follow a 5-step process to figure out whether or not you meet their criteria for disability. You must meet all 5 criteria to be considered disabled.

Steps 1, 4, and 5 of the Social Security disability determination process look at your ability to work. Steps 2 and 3 are concerned with your medical condition and whether it prevents you from working.

Step 1: Are You Working at a Level of Substantial Gainful Activity?

If you are working and your countable gross monthly earnings (your earnings before taxes are deducted) are higher than the Substantial Gainful Activity (SGA) level, you will not be considered disabled and you will not qualify for SSDI benefits. In 2019, SGA for people with disabilities is $1,220 ($2,040 if you are blind).

If you are not working or if your earnings are less than the SGA level, Social Security will move on to the next step to decide if you are disabled.

Example

Cassandra earns $22.00 per hour and works 60 hours per month. Her gross monthly earnings are $1,320 ($22.00 x 60), though after taxes are deducted, her actual paycheck is only $1,120.

Even though Cassandra only gets $1,120 per month in checks, Social Security counts all of her $1,320 in gross monthly earnings. Since $1,320 is more than the SGA level ($1,220), Social Security says she does not have a disability.

If you are self-employed, make sure to read all of the information about SSDI and people who are self-employed, so that you understand some special rules about how SGA is calculated for people who are self-employed.

Deductions

If you have a job, but your disability doesn’t let you work enough to pay your bills, you can still apply for SSDI benefits. If your income is greater than the SGA limit, there are some ways to lower your gross monthly earnings so that Social Security won’t count everything you make. These are called deductions. Common deductions include Impairment Related Work Expenses (IRWEs), subsidized earnings, and sick or vacation pay. You will have to supply documentation of these deductions when you submit your SSDI application.

SSDI deductions can help you qualify for SSDI when you would not qualify otherwise. They are explained in greater detail in the Extended Period of Eligibility portion of this article.

Step 2: Is Your Medical Condition Severe?

To be considered disabled, your medical condition must be expected to last at least 12 consecutive months or to result in death.

If your medical condition is not expected to result in death, it must significantly limit your ability to perform basic work activities for at least 12 months. This means your medical condition must prevent you from doing things like thinking, talking, or walking. If it does not, you will not be considered disabled and will not qualify for SSDI benefits.

If your disability meets this standard, Social Security will move on to the next step to decide if you are disabled.

If your disability will last less than 12 months

If your disability is not severe enough for SSDI, because it will last less than a year, but it prevents you from working in the meantime, apply for State Disability Insurance (SDI). SDI is a short-term insurance program for Californians who work and then become disabled. You should also speak with your employer and check if you are covered by a private disability insurance plan.

Step 3: Is Your Medical Condition on Social Security’s List of Impairments?

Social Security’s List of Impairments includes numerous mental and physical disorders. If your disabling condition is on the list, Social Security will decide that you are disabled and will skip steps 4 and 5.

If your condition is not on the list, Social Security will decide whether your condition is as severe as a condition that is on the list. If your disabling condition is as severe, Social Security will decide that you are disabled and will skip steps 4 and 5.

If it is not as severe, Social Security will move on to the next step to decide if you are disabled.

Step 4: Can You Do the Same Work You Did Before?

If your condition doesn’t prevent you from doing the work you did before, you won’t be considered disabled and will not qualify for SSDI benefits.

If your medical condition does prevent you from doing the same work you did before, Social Security will move on to the final step to decide if you are disabled.

Example

Alex worked as a construction worker. He fell off his motorcycle one day and severely injured his knees. Because he has limited mobility and can no longer stand for long periods of time, he can no longer work as a construction worker.

Alex cannot do the same work he did before and SSA will continue look into whether he meets the other 4 criteria for being considered disabled.

Step 5: Can You Do Any Other Type of Work?

If you can’t perform the work you used to do, Social Security will evaluate your skills and your condition to see if there is other work you could do at the Substantial Gainful Activity (SGA) level.

If your condition doesn’t prevent you from doing other work and earning at the SGA level, you won’t be considered disabled and will not qualify for SSDI benefits.

Example

While Alex’s injury prevents him from doing construction on site, he still might be able to manage construction projects from a desk, so Social Security might not considered him disabled.

If your medical condition does prevent you from doing other work and earning at the SGA level, Social Security will decide that you have a disability, as long as you met the other 4 criteria and all other program requirements.

If you are insured and have a disability, you may qualify to get SSDI benefits.

Note on Blindness

Social Security uses special rules to decide if someone is blind. Generally speaking, if your vision cannot be corrected to better than 20/200 in your better eye, you’ll be considered blind. Click here to learn more about Social Security rules on blindness.