YOUR PRESENT EMPLOYMENT STATUS
- Are you working?
Yes.
No.
If you answered yes, you probably will not qualify for Social Security disability benefits.
Social Security disability benefits are paid to individuals who are not able to work due to a severe medical condition. So, if you are working, it is likely that you are not eligible to receive disability benefits. However, all work is not created equal. Only work that qualifies as “substantial gainful activity” will bar your claim. “Substantial gainful activity” is work that requires significant physical or mental activity, for which you earn more than a minimum amount established by Social Security. In 2021, that amount is $1,310/month. Chances are that your case will also be denied if your income is less than, but close to this amount. If you are working and your work rises to the level of substantial gainful activity, then you are not eligible to receive Social Security disability benefits, regardless of the severity of your medical condition.
If you are not currently working at the level of substantial gainful activity, you have cleared the first hurdle to obtaining Social Security disability benefits. You will be awarded benefits if you meet the other requirements established by Social Security.
THE NATURE OF YOUR IMPAIRMENT
- Which of the following more accurately describes your situation?
A.) I have a short-term medical condition that makes it difficult (sometimes, impossible) for me to perform basic work-related activities at the present time. OR
B.) I have a medical condition that makes it impossible for me to do basic work-related activities, and my condition is expected to last for at least a year.
IF YOU ANSWERED A —
You will not qualify for Social Security disability benefits. Social Security disability benefits are not available for a partial or short-term disability.
IF YOU ANSWERED B —
You have cleared the second hurdle to obtaining Social Security disability benefits.
- Has your impairment been diagnosed and documented by a medical doctor?
Even if you have a severe impairment that prevents you from working, the Social Security Administration will not just take your word for it. You need to provide Social Security with proof that you have a “medically determinable” impairment. A “medically determinable impairment” is a physical or mental impairment that has been documented by medically accepted tests and diagnostic techniques. Generally, this includes the type of objective evidence found in your medical records: the results of the doctor’s examination (“clinical findings”); lab reports; X-rays and other scans; etc. Moreover, this proof must come from an acceptable medical source.
IF YOU ANSWERED yes, an adjudicator will decide whether you have provided enough medical documentation. An experienced attorney is crucial for this step.
IF YOU ANSWERED No
Without objective medical evidence from a licensed medical doctor or psychologist, your claim is likely to be denied on the ground that you do not have a “medically determinable” impairment. You may, however, be able to obtain this evidence if you begin treatment.
- Is your condition listed in the Social Security Administration’s Listing of Impairments?
The Listing of Impairments describes more than 100 physical and mental conditions that Social Security deems to be severe and disabling as a matter of law. You can view the Listing of Impairments on the Social Security Administration website.
Yes.
No.
IF YOU ANSWERED Yes
You are disabled and you qualify automatically for Social Security disability benefits. An experienced attorney will know how to help you prove that your impairment meets the specific requirements.
IF YOU ANSWERED No
You are not automatically qualified for Social Security disability benefits, but this does NOT mean that your claim automatically will be denied. You still may qualify for Social Security disability benefits if you meet other, criteria. Basically, there is more than one way to prove that a person is disabled.
- Are you able to do any of the types of work you have done previously in the past 15 years?
Yes.
No.
IF YOU ANSWERED Yes
You are not disabled. Accordingly, you do not qualify for Social Security disability benefits and your claim will be denied.
IF YOU ANSWERED No
You may qualify for Social Security disability benefits. Social Security will carefully review your employment history and assess whether you are able to perform any “past relevant work.” This means any job you did in the past 15 years that required significant physical or mental activity, and which you performed long enough to master. Even if you cannot do the work now in the same way that you did it in the past, if you are able to do the job the way it generally is done in the national economy, Social Security will find that you are able to do the work and, therefore, are not qualified to receive disability benefits. This can be a difficult hurdle to overcome, but if Social Security finds you can no longer do your past work, then you will qualify for benefits if you can clear the final hurdle, as explained in Question 6.
- Are you able to do any other work?
Yes.
No.
IF YOU ANSWERED Yes
Even if you cannot do your previous work, if you are able to do any other work, even at a lower pay rate, then you do not qualify for Social Security disability benefits, and your claim will be denied. In making this assessment, Social Security will consider your “residual functional capacity” (that is, what you are
capable of doing, despite your disability) and related vocational factors (your age, education, work experience and transferable skills) to determine if you can adjust to different work than you have done in the past.
IF YOU ANSWERED No
You have cleared every hurdle. You are totally disabled, and you qualify to receive Social Security disability.
Please remember, the Social Security Administration is a large government bureaucracy, with tens of thousands of employees. The sheer size of the SSA makes dealing with it difficult. As a former SSA Supervisory Staff Attorney, Ms. Stone has worked inside the system and she has had success in navigating the system for hundreds of disabled clients. For questions 5 and 6, if your case goes to hearing, the Administrative Law Judge will probably ask a Vocational Expert to testify. An experienced attorney, like Ms. Stone, will know how to ask questions so that the Vocational Expert actually helps to prove your case.
