Medical Conditions That Qualify For Social Security Disability
Americans no longer able to work due to a mental or physical disability often wonder: does my condition qualify for social security disability benefits? Social security disability insurance is a federal government benefit earned by working and paying FICA taxes just like social security retirement. Many who ask what conditions qualify for disability are under a mistaken impression that only certain mental or physical conditions are serious enough for disability payments. But the issue for social security disability is less about the name of the condition and more about the impact that condition has on the ability to work. Any legitimate medical condition referred to in social security disability parlance as a medically determinable impairment can be the basis for social security disability insurance benefits. To be a medically determinable impairment the condition must be diagnosed with medically acceptable criteria by a medical doctor or health professional, as well as supported by acceptable laboratory and objective medical evidence.
Fact: Ssdi Payments Dont Kick In Immediately
Processing can take three to five months, according to the Social Security Administration. When your request is approved, you will receive a letter with the effective date. Your first payment will be for the sixth full month following your disability effective date, according to Social Security.
For example, if you get a letter that approves your claim and sets a disability effective date of January 15, your first payment will be for the month of July. But youll actually get that payment in August, since payments are made one month after the month they cover.
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Does A Medical Condition Have To Match The Listing
An applicant filing for Social Security disability benefits doesn’t necessarily have to satisfy the exact listing requirements for a particular illness or condition to be awarded disability benefits based on the condition. You can be awarded disability benefits if Social Security considers aspects of your condition medically equivalent to the criteria in the listing or a related listing. This is called “equaling a disability listing.”
Alternatively, you can be eligible for disability benefits if you don’t meet or equal the criteria for the medical listing, if your condition limits your functioning so much that you can’t work. Social Security will consider the effect of your condition on your capacity to perform routine daily activities and work and will then determine whether there is any kind of job you can safely be expected to do. This is called qualifying “vocationally” for disability benefits. For more information, see our section on how Social Security decides if your limitations make you disabled.
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Need Help Applying For Social Security Benefits
The application process for Social Security disability payments can be complicated and confusing. If you need help, complete the form to be connected with an experienced Social Security Disability attorney. An attorney has experience with the application process and can guide you through the process.
Talk To A Social Security Disability Lawyer For Free Today
The Social Security Disability process is long and stressful. But you dont have to handle it alone. A Social Security Disability lawyer can help. John Foy & Associates has been assisting disabled individuals for over 20 years. We know what the SSA looks for to approve a claim.
Get help to file your SSD application or appeal a rejection at no risk today. We do not charge you unless you get paid. Call us or contact us online to get started with a free consultation.
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How Do You Qualify For Social Security Disability Benefits
Disability benefits are available to qualified recipients under two programs, Supplemental Security Income and Social Security Disability Income . SSI is a means-tested program for people with disabilities who have very limited means, but SSDI is an insurance program that is available to qualified workers with disabilities regardless of their resources. As of January 2018, some 13.8 million disabled workers and their dependents were receiving SSDI benefits from Social Security.
SSDI pays cash benefits to people who are unable to work for a year or more because of a disability. Benefits continue until you are able to work again on a regular basis, or until you reach retirement age. At that point, the disability benefits automatically convert to retirement benefits, but the amount remains the same. After receiving SSDI benefits for two years, you also become eligible for health insurance coverage under Medicare. The disability program also includes a number of work incentives to ease your transition back to work.
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Who is eligible?
As with retirement benefits, you must have accumulated a certain number of work credits before you can qualify for SSDI disability benefits. However, fewer credits are required to qualify for the disability program than for retirement. You can earn up to four credits per year of employment. How many credits you need to qualify for disability depends on the age you become disabled.
Who is disabled?
Benefits For A Disabled Child
A child under age 18 may be disabled, but we don’t need to consider the child’s disability when deciding if he or she qualifies for benefits as a dependent. The child’s benefits normally stop at age 18 unless he or she is a full-time student in an elementary or high school or is disabled.
Children who were receiving benefits as a minor child on a parents Social Security record may be eligible to continue receiving benefits on that parents record upon reaching age 18 if they are disabled.
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Common Respiratory Disorders That May Cause Disability
COPD is an umbrella term that includes several lung diseases, including emphysema, bronchitis, and sometimes asthma, which cause coughing, wheezing, and shortness of breath. Those with COPD exhibit reduced breathing capacity due to obstructed airflow into and out of the lungs. The most common cause of COPD is smoking, and quitting smoking will usually stabilize symptoms, if not always improve them.
COPD is typically diagnosed through spirometry, a pulmonary function test that measures the amount of air that can be inhaled and exhaled over a certain period. Asthma can be partly diagnosed by a pre-bronchodilator and post-bronchodilator spirometry test, but a doctor must also look at the patients medical history and physical exam.
Many of those diagnosed with COPD also suffer from sleep apnea, a condition which not only impacts the ability to obtain meaningful rest but can also severely impair daytime functioning. Sleep apnea is diagnosed based on a combination of self-reported symptoms and objective testing, typically a sleep study. The most common therapy is a CPAP machine, which pumps a steady stream of air into a mask to keep the airways unobstructed during sleep.
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Ive Heard That My Ssdi Payments May Be Reduced If I Receive Other Benefits How Does This Happen
If you receive other disability benefits such as Workers Compensation, your benefits may be recalculated or reduced. This may take place based on the SSDI index which is also the same index used to compute all Social Security benefits. The SSDI index looks at average wage indexes and applies them to a beneficiarys average current earnings.
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Listing 600 Genitourinary Disorders
Genitourinary Disorder refers to a disorder that impacts your kidney function, urinary tract or your reproductive system. Typically you will need to be required to receive dialysis for your genitourinary condition to qualify to receive benefits and the SSA will evaluate your case based on your medical history, your renal function before dialysis, copies of your biopsies, a complete record of your therapy attempted and how the condition impairs your ability to work. Common conditions included in this category include Diabetic Nephropathy, Kidney Failure, and Kidney Cancers. View full Blue Book List here
Appeals And Legal Advocates
Do not be discouraged if you have to appeal your claim for SSDI benefits. You are in the majority. Only 38 percent of first-time applications are approved, meaning 62 percent are denied. The appeals process requires great attention to detail and deadlines. The rules and procedures governing SSDI can be very complicated and confusing. Having an advocate, someone who can help you deal with the paperwork and deadlines involved in the process, is not required, but can be very helpful.
There are four levels in the appeals process: reconsideration hearing appeals council and federal court. It is a step-by-step process, meaning you begin with reconsideration and only move on to the next level if your appeal is denied. If you win your appeal at any step along the way, you will begin receiving benefits.
You can handle your own Social Security appeal or choose a lawyer or friend to help. That person is called a representative and cant collect a fee from you without first getting written approval from Social Security.
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Wait Time For Decisions And Hearings
The amount of time it takes for an application to be approved or denied varies, depending on whether it is an initial decision or a decision based on an appeal. In fiscal year 2019, it took an average of 120 days for SSA to make an initial determination on a disability claim. The figure increased following the COVID-19 pandemic and, for months in fiscal year 2021, the average wait time for an initial decision is 165 days.
The high number of cases and long wait times for a hearing before an Administrative Law Judge has drawn significant attention from Congress in recent years. Congress provided additional funding for this workload and the number of cases and wait times have declined. In fiscal year 2020, the average wait time for a hearing was 386 days .
For some cases, SSA will expedite disability determinations. These include Quick Disability Determination and Compassionate Allowance cases. These are cases where statistical models or medical diagnoses indicate the person has an extremely severe medical condition. These cases can often be processed in under 30 days. Additionally, many cases involving military veterans are expedited.
Musculoskeletal System And Connective Tissue
The SSA reports that the largest category of diagnoses among disabled workers receiving disability benefits was diseases of the musculoskeletal system and connective tissue. These disabilities, which represented 32.3 percent of the diagnoses, involve damage to ones nerves, muscles, tendons or ligaments. Examples of this type of disorder include:
- ArthritisAn individual with rheumatoid arthritis, a disorder of the immune system, must experience significant limits on his or her ability to work to qualify for benefits under this medical diagnosis. Rheumatoid arthritis is sometimes referred to as a connective tissue disorder.
- Back pain Abnormal curvature of the spine may affect an individuals ability to walk as well as the function of other body systems. The intensity of back pain and the limitations on an individuals ability to function are considered in a disability diagnosis related to back pain.
- FibromyalgiaFibromyalgia is a complex syndrome in which a person has widespread pain in the joints, tendons, muscles and soft tissues that lasts for more than three months. Claims reviewers will try to assess whether there is adequate evidence to show that the condition limits a persons ability to perform any type of gainful work.
- Reflex Sympathetic Dystrophy RSD describes a range of symptoms that may occur from injury, diseases or surgery. RSD is characterized by intense burning or aching pain typically caused by trauma to a single extremity.
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Respiratory Disease Patients And Ssd Eligibility
If you have any of the following respiratory diseases, or other chronic inflammatory lung or obstructive lung diseases, you may qualify for SSD benefits:
- Pulmonary embolism
- Acute Respiratory Disease
- Cystic Fibrosis
Remember, the Social Security Administration has certain guidelines for determining whether or not a person is disabled. Millions of Americans have a type of lung disease, but SSD benefits are only available to those whose conditions are truly severe.
To be eligible for SSD benefits, your respiratory disease must:
- Prevent you from working full-time
- Have lasted, or is expected to last, for at least one year
- Be life-threatening
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What Are The Eligibility Requirements To Get Social Security Disability Benefits
To qualify for Social Security disability benefits, you must have worked long enough in jobs covered by Social Security . Then, you must have a medical condition that meets Social Security’s definition of disability.
In general, we pay monthly benefits to people who are unable to work for a year or more, or who have a condition expected to end in death. The disability must be so severe the worker cannot work, considering age, education and experience.
If you think you may be eligible to receive disability benefits and would like to apply , you can use our online application.
Applying online for disability benefits offers several advantages:
- You can start your disability claim immediately. There is no need to wait for an appointment
- You can apply from the convenience of your home, or on any computer and
- You can avoid trips to a Social Security office, saving you time and money.
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How Do I Know If I Have Worked Enough To Qualify For Ssdi
To qualify for SSDI, you must have paid enough into the Social Security system during the years you were working. In addition, you must have worked recently enough .
Social Security uses a system of work credits that are based on your annual income. A person can earn up to four credits per year.
In general, you will need 40 credits to qualify for SSDI, and 20 of those must have been earned in the past 10 years. However, the number of credits you need can vary depending on your age.
To learn more about how your work history affects your SSDI eligibility, read the Social Security Administrations booklet How You Earn Credits.
We Are With Those Who Need A Helping Hand
The Supplemental Security Income program is a program that provides income support to people with disabilities, people age 65 or older, or blind, who have low income and resources. U.S. Treasury general funds, not the Social Security trust funds, pay for SSI.
If you or someone you know may be eligible for SSI, visit to learn more and apply.
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Which Medical Conditions Are Likely To Qualify For Disability
While any of the above medical conditions are SSDI and SSI qualifying disabilities, some medical conditions are more likely to lead to an approval of benefits than others. We recently surveyed our readers about their experiences in applying for disability benefits and compared their answers to government statistics. The conditions most likely to get approved were multiple sclerosis and some types of cancers. Respiratory disorders and joint disease were also high on the list. For the details, see our article on survey statistics on getting Social Security disability for common medical conditions.
Congenital Disorders That Affect Multiple Body Systems
There are two impairments that fall into this category: Non-mosaic Downs Syndrome and all other conditions that affect multiple body systems. Non-mosaic Down Syndrome is Down Syndrome in which all of the bodys cells are affected and can cause impairments in vision, hearing, the heart, and more.
Other conditions that affect multiple body systems are congenital disorders that cause deviation or interruption to the normal function or development of the body. Other recognized condition that affect multiple body systems include Caudal Regression syndrome and Fragile X syndrome.
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Document Your Physical Symptoms
Long haul Covid-19 may present a vague set of symptoms, not unlike other conditions such as fibromyalgia or chronic fatigue that have also been approved for Social Security disability benefits.
However, these types of conditions are more difficult to prove because they generally cannot be diagnosed with one medical test.
Those arent going to be awarded as quickly, because you need to see those over a period of time, Geist said. You need a longitudinal history there, and those can be more difficult to document.
The best way to establish a record of your symptoms is to share them with your doctor and to have them document what is going on.
For example, if you have migraines, how long do they last? What does your recovery process look like?
Keeping track of those details will help if your application has to be considered by a judge, Geist said.
How Do You Qualify For Ssdi
To qualify for SSDI, you need to meet some basic requirements.
- You must have earned a sufficient number of work credits.
Work credits are basically points you accumulate by earning, and paying Social Security taxes on, a certain amount of money. In 2018, you earn one work credit for every $1,320 in wages or self-employment income. You can earn four credits per year, so once youve earned $5,280 in taxable income in a year, you cant earn any more credits until the next year.
The specific number of work credits you need to qualify for SSDI will vary depending how old you are when you become disabled. As a general rule, you can potentially qualify if youve earned at least 20 credits in the 10 years prior to becoming disabled and if youve earned a total of 40 credits or more.
However, if youre younger when you become disabled, the work credit requirement is reduced based on age. For example, if youre under 24 when you become disabled, you can become eligible for SSDI if youve earned at least six work credits in the three year period before your disability occurs.
If youre between the ages of 24 and 31, you can qualify if youve earned work credits at least half the time between age 21 and the time you develop your disability. If youre between the ages of 31 and 62, theres a chart showing the number of credits you need.
- You cannot be engaged in substantial gainful activity
- You have to meet the definition of disabled
- You must be unable to do any job youre qualified for
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