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SSDI Applicant Qualifications

As a federal income benefits program, Social Security Disability Insurance (SSDI) helps disabled Americans pay for their basic needs. Generally, benefit recipients can’t work for a year or more due to a prolonged or disabling medical condition. To qualify, you must have already been paying the Social Security payroll tax deduction and earned enough credits to be eligible, as SSDI is an earned benefit. Your credit depends on your work history. You must also meet qualifying medical conditions for SSDI corroborated by your medical doctors and health records.

The Difference Between SSDI and SSI

SSDI differs from Supplemental Security Income or SSI, but it is possible to receive both benefits simultaneously. SSI is a federal income supplement program that receives funding via general tax revenues rather than Social Security taxes; however, qualifying medical conditions for both programs are the same. Filing a claim to receive SSDI can be time-consuming and complex to get right the first time. Initial claims receive frequent rejection due to inadequate medical proof and records.

Hiring a Disability Attorney

It is worth retaining the services of a Social Security disability attorney to help guide you through the application process, ensuring your claim is well-supported with medical documentation. Even after your claim is approved, you will have to wait five months before receiving your first SSDI benefits payment. In essence, you will receive your first payment in the sixth full month after the Social Security Administration determines the date your disability began.

DDS Verification

Social Security field representatives usually receive a claimant’s application for disability benefits in person, by phone, mail, or online filing. The field office is tasked with verifying the non-medical eligibility requirements such as age, marital status, employment, or Social Security coverage data. Then the field office sends the case to DDS for disability evaluation. The Disability Determination Services DDS is a federally funded state agency that will make the initial determination whether a claimant is by law either blind or disabled.

The DDS, by default, tries to obtain medical claim evidence from the applicant’s medical sources first. If they find the evidence insufficient or unavailable to make a determination, the DDS will schedule a consultative examination (CE) to get additional medical information. When the medical evidence is satisfactory, trained staff at the DDS make their initial disability determination. At this point, the claim is returned to the field office to take appropriate action.

The Social Security Administration Blue Book

Medical conditions that may meet the stringent requirements for the SSA’s definition of disability are in the SSA’s Blue Book; Part A for adults and Part B for children. The Blue Book divides into three main chapters covering:

  • Part 1 General information – This chapter is a broad description of disability benefit programs and the Social Security Administration’s procedures of claim assessment, including the role of medical professionals and experts.
  • Part 2 Evidentiary Requirements – This chapter reviews the type of paperwork, examinations, and other evidence officials use to make a disability determination.
  • Part 3 Listing of Impairments – This chapter details the disability standard for adults (Part A) and children (Part B), outlining the medical conditions or families of related conditions. The chapter describes what evidence officials weigh in claim evaluations by types of disorders or affected bodily systems like neurological disorders, respiratory illnesses, vision and hearing loss, etc. The list is extensive.

Ten conditions that Commonly Qualify for Disability

  1. Arthritis and other musculoskeletal disabilities – These conditions can lead to an inability to walk or perform dexterous tasks like writing or typing.
  2. Heart Disease – Heart disease is one of the deadliest medical conditions in the US. It has many subsets of disease types that can qualify for a disability like congestive heart failure or a congenital heart defect.
  3. Degenerative Disc Disease (DDD) – This is another musculoskeletal disorder typically affecting adults aged sixty or more. DDD can be so disabling it can render people unable to walk or sit in a position for more than two hours due to excruciating pain.
  4. Respiratory Illnesses – One of the most common SSDI qualifiers is chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis. COPD is a group of diseases causing blocked airflow and breathing problems.
  5. Stroke – Another common yet deadly illness leaving many people with partial paralysis, inability to walk unassisted, and trouble with verbal and non-verbal communication impeding the ability to work.
  6. Cancer – Most cancers at stage III and beyond will qualify for SSDI. Certain aggressive cancers (i.e., liver cancer) will qualify with just the diagnosis.
  7. Diabetes – As a stand-alone illness, diabetes is not a disabling condition since millions of Americans can manage their condition. However, when complications become severe enough to affect daily living, like glaucoma, making you legally blind, or becoming too obese to walk, you can qualify for SSDI.
  8. Nervous System Disorders – Conditions like cerebral palsy, which can affect a person’s ability to move and maintain posture and balance, and epilepsy which can cause seizures, are commonly eligible for SSDI.
  9. Mental Illnesses – Nearly twenty percent of SSDI recipients have a mental illness like autism or suffer from a mood disorder like anxiety or depression. While a mental illness is not a guarantee for SSDI benefits, it is in the top ten qualifying conditions for disability.
  10. Immune System Disorders – These disorders include viruses like HIV or autoimmune illnesses like rheumatoid arthritis.

Other Qualifying Conditions

While these are the ten most common disability qualifiers, many more are in the Blue Book. Certain conditions will automatically qualify you for disability. The SSA has a list of these conditions, which will process and meet approval faster under the Compassionate Allowances Program. More than two hundred compassionate allowance conditions will provide expedited benefits. These conditions include advanced forms of cancer, advanced chronic heart failure and other cardiovascular system disorders, ALS, Parkinson’s and other neurological disorders, early-onset Alzheimer’s disease, and blindness or other visual disorders.

Establishing the Compassionate Allowance Program fast-tracks eligible claimants through the long and often frustrating disability claims process to receive much-needed benefits promptly. Compassionate Allowance is crucial due to the person’s shortened life span prognosis since, typically, the SSA takes between six to twelve months to issue a disability benefits claim determination.

If you become disabled or have a condition or illness with a prognosis eventually rendering you disabled, SSDI benefits can improve your economic outlook when you can no longer work. The SSA has extensively documented medically qualifying conditions for SSDI. Your disability lawyer can help you draft a comprehensive claim for disability benefits. Your attorney can also explain if you are eligible to receive SSI concurrently with SSDI. Explore the options available for SSDI benefits if you think you have a qualifying medical condition.

For assistance, please contact our Forty Fort office or call (570) 288-1800.

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