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How does the SSA determine disability for SSDI eligibility?

| May 10, 2021 | Social Security Disability

A serious illness or injury can disrupt your life and make it impossible to carry out specific tasks, including those necessary to do your job. 

Under these circumstances, you may be eligible for Social Security Disability (SSDI). However, it will be up to the Social Security Administration (SSA) to determine if your condition is indeed disabling.

Three rules of determining disability

Per the SSA website, the general criteria for determining disability for the purposes of SSDI eligibility include:

  1. Being unable to work because of your medical condition
  2. Being unable to perform any substantial gainful activity because of your condition
  3. An expectation that the condition will last at least a year.

This may seem like a simple enough list of rules, but it can be surprisingly complicated.

For instance, people often feel they cannot work, but the SSA may not have the evidence to reach this same decision. Or an individual may have an unusual condition that is not easily understood by non-medical professionals and does not appear on the list of conditions the SSA recognizes as severe.

There are also situations where a person has several conditions that may not be disabling independently, but collectively, they can make it impossible for someone to work.

Making your case

Because of these challenges, it is crucial to be thorough and accurate when applying for disability benefits. Document every doctor’s visit and diagnosis; retain test results and notes that may or may not appear in your medical records. 

With sufficient information, the SSA can more easily determine whether a condition is disabling. 

Unfortunately, the SSA will deny most applications the first time around. It is important not to lose hope in these situations. You can appeal the decision.

To make the application and appeals processes easier, though, you can work with an attorney to prepare your application or appeal. Chances are that you do not have experience navigating the Social Security system or proving the extent of your condition. Thus, seeking guidance from someone familiar with the process can help you avoid costly missteps and delays in getting the benefits you need.