How Are Disability Benefits Determined?

Submitted by CM on

The Social Security Administration (SSA) and Disability Determination Service (DDS) will determine if you are eligible for benefits by examining different parts of your claim. They will then use that information to determine how much you’ll receive in benefits.

They will take into consideration whether you are working or able to work, how severe your medical condition is and if it can be found in the SSA’s Blue Book which is a list of medical conditions which qualify for disability benefits.

They will also look at your record to see how much disability insurance you have through the work credits you have accumulated and whether these are sufficient to be eligible for Social Security Disability Benefits (SSDI).

If you don’t have enough you may still get a benefit but it will be Supplemental Security Income (SSI) which is means tested so what you get will depend on your assets and any income you earn.

Are you working?

The SSA will look at if you’re working or not as one of the qualifications for eligibility for Social Security Disability Benefits is that your medical condition prevents you from working for at least 12 months.

Is your condition “severe”?

Your condition needs to be severe enough that you are unable to work in any type of job.

If you are unable to provide sufficient medical evidence that proves that your disability is serious the SSA may request that you take part in a Residual Functioning Capacity (RFC) test which is conducted by your doctor who tests your physical and mental capacity such as your ability to move around, sit and stand in one position for extended periods of time, how much you can lift and how well you can concentrate on different tasks.

Is it found in the Blue Book?

The SSA will determine if your condition is in the Blue Book because if it is your application for disability benefits is more likely to be approved. Sometimes a medical condition doesn’t come under a separate listing but is part of several lists so this often makes it more difficult to confirm your eligibility for disability benefits.

Can you work?

The SSA will determine if you can do the work you’ve previously done or if there is other work that you may be able to do. If it finds that you can still work you are less likely to get your claim approved.

Sometimes the SSA looks at your age and it considers if you are older you are less likely to be able to pick up the skills of a new job so you are more likely to get your disability application approved.

Get Help Determining If You Are Eligible

A lawyer or advocate may be able to help figure out if you are eligible for benefits. They can look at your disability insurance record to help confirm that you have earned enough work credits. If you need help understanding your disability insurance record you should contact an attorney or advocate for a free case evaluation.

Additional Resources

Add new comment

Find Out If I Qualify for Benefits!