How to Qualify for Social Security Disability Insurance Benefits
Disability benefits are available to people who become unable to work for at least 12 months due to health problems. However, many people applying for Social Security disability don't know all the federal government's different eligibility requirements. Unfortunately, your health problems alone aren't nearly enough to help you qualify for benefits. Make sure you meet each individual requirement before filing your benefits application!More Guides
Make Sure You Have Social Security Disability Insurance Coverage
Social Security Disability Insurance (SSDI) is a federal policy that workers pay for through payroll taxes. Your employer deducts FICA taxes (also known as Social Security taxes) that cover your monthly SSDI premiums from every paycheck. You must have current, active SSDI coverage at the time you apply for benefits in order to qualify. Here's how you can confirm that:
- Are you at least 18 years old and living in the United States? This is the first step to determining if you have active SSDI coverage. Only working-age U.S. residents can qualify for SSDI.
- Have all your jobs been with employers that withheld FICA taxes from every paycheck? Some people work in jobs that don't withhold Social Security payroll taxes. This includes unionized jobs (i.e., teachers, firefighters), service-industry workers (bartenders, wait staff) and seasonal or temporary employees.
- Are you currently receiving any Social Security benefits? You must answer “no” to this question in order to qualify for SSDI. SSDI helps Americans forced to stop working due to health issues tap into Social Security benefits before full retirement age. Once you turn 66 years old, SSDI benefits automatically convert into regular Social Security payments. So if you're aged 66+ (or 62 and already drawing Social Security early retirement), then you cannot receive SSDI benefits. The SSA considers that double-dipping, which is illegal under current federal law.
Confirm You Have Enough Social Security Work Credits
Many people who apply haven't worked recently or enough years to qualify for SSDI benefits. You must have already earned 40 Social Security work credits (20 in the last 10 years) in order to qualify. For most people, that means working 5 in the last 10 years full-time for jobs that withheld FICA payroll taxes. You cannot earn more than 4 Social Security work credits in any calendar year. In 2023, your employer must pay you $1,640 in any three-month period to earn one Social Security work credit. In addition, once you stop working for 60 months in a row, your SSDI coverage automatically lapses. So if you've been out of work more than 5 years when you apply, you cannot get SSDI benefits.
Your Total Individual Income Must Be Less Than $1,470 Per Month
In most cases, it's best to apply as soon as your health problem forces you to stop working. That's because if you're still working and earn more than $1,640 per month, you won't qualify for SSDI benefits. In fact, the SSA has a monthly income limit they call the “substantial gainful activity” threshold. Once you cross that boundary, you're not eligible for SSDI. Know that income you get from any source can push you over the SGA limit, like child support or alimony.
Your Health Issue Must Stop You From Working 12+ Months or Be a Terminal Illness
Believe it or not, how much pain you're in and your doctor's diagnosis is less important than you think. Here's what the SSA looks at when deciding whether or not your issue meets their definition of “disability”:
- You cannot qualify for SSDI benefits if you're still working when you apply. Working part-time or light duty only isn't enough to meet SSDI medical eligibility requirements.
- How does your health problem(s) specifically limit your ability to perform your usual work tasks? For example: Does your doctor say you need to prop one leg up regularly throughout the day? Do you need to alternate sitting and standing over an eight-hour period? Can you drop a pencil and pick it back up without another person helping you? Can you walk up and down a few steps or across a room without using some kind of mobility assistance? Are you able to remember and follow verbal directions from your supervisor throughout the workday?
- If you can't do the work you did before, can you find another job that pays a similar amount? In other words, is there any other work you can do with your current mental or physical limitations? If the SSA can find another employer who's willing to hire you as-is, then you won't qualify for SSDI.
- Does your doctor expect your condition to improve in less than a year so you can go back to work? SSDI doesn't cover temporary or short-term disabilities like recovering from knee-replacement surgery. You must be completely unable to work for 12 months in a row to qualify as disabled.
- Is your disability a terminal illness or other condition on the SSA's Compassionate Allowances (CAL) list? The CAL list includes over 200 rare diseases and terminal illnesses pre-approved for Social Security disability benefits. If your doctor diagnoses you with cancer, Lou Gehrig's disease or another rare but serious condition, you're almost certainly disabled.
Tips To Help You Qualify for Social Security Disability Insurance Benefits
Get copies of your complete medical records from all doctors who treat your disabling condition before you apply. You must submit convincing medical evidence in order to prove you're truly unable to work. So, these records are crucial to prove your case!
It's much easier to qualify for SSDI once you're between 50 and 66 years old. The SSA uses special “grid rules” that make people aged 50 and older more likely to qualify for SSDI. These rules factor in things like work history, job skills and education level when deciding whether or not you're disabled.
Having a disability lawyer file your claim makes you 3x more likely to get approved on your first try. The SSDI application is 3 different claim forms and requires detailed evidence to support your case. Attorneys know how to fill these forms out perfectly and what paperwork you must include to get approved. Plus, they all work on contingency, so you'll pay $0 for legal assistance unless your case wins. And if you do get approved, you'll only pay a small, one-time fee under federal law.
List every condition you have as well as all your symptoms and prescription drug side effects. Nearly 2/3 of people currently getting SSDI benefits each month listed 2-6 conditions on their claim forms. One health problem is almost never enough to meet the SSA's internal definition of “disabled.”