If you become disabled before you can retire from work, you may be eligible for disability benefits under the Social Security Act. Under that Act, a worker who is found to be blind or disabled is entitled to Social Security disability insurance (SSDI) benefits.
Qualifications for SSDI Benefits
To qualify for disability benefits, you must:
- be younger than full retirement age
- have insured status" for disability, which means that you have earned enough money in the required number of years before the disability began
- have a qualifying disability, and
- file an application for benefits, either online or on paper.
Determination of Disability
The Social Security Administration (SSA) defines disability as the inability to do one's previous job or any other substantial amount of work due to a severe physical or mental impairment. The impairment must be diagnosed and documented by a doctor and must last—or be expected to last—for at least 12 months (or to end in death).
The SSA uses a five-step evaluation system for determining whether a worker is disabled. The major questions to be answered, in order, are the following:
- Step One: Is the person currently working and engaged in "substantial gainful activity"? If the answer is yes, the person is not considered disabled, regardless of medical condition. If the answer is no, go to Step Two.
- Step Two: Does the person have a severe medical impairment or combination of impairments that can be expected to last for a continuing period of one year or result in death, and which significantly limits the ability to do basic work activity? If the answer is no, the person is not disabled. If the answer is yes, go to Step Three.
- Step Three: Is the impairment (or combination of impairments) the same as or equal to an impairment found in Social Security's Listing of Impairments? If the answer is yes, the impairment is automatically presumed to be so severe that the applicant would not be able to do gainful activity, and the person is considered disabled. If the answer is no, go to Step Four.
- Step Four: What is the person's ''residual functional capacity''? Does the person retain sufficient mental and physical capacity to meet the demands of the person's former work? If the answer is yes, the person is not disabled. If the answer is no, go to Step Five.
- Step Five: Does the person have sufficient residual functional capacity, when considered with the person's age, education, and work experience, to be able to undertake other work activity that is less physically or mentally demanding?
In steps one through four, the burden to prove a disability is on the applicant, but the burden shifts to the government at step five. This means that, at step five, Social Security must show that there are jobs that the applicant can do despite their limitations; the applicant doesn't have to prove that there aren't any jobs they can do.
Amount of Social Security Disability Benefits
If you're approved for disability benefits, you will not receive benefits for the first five months following the onset date of your disability. Starting in the sixth month, your monthly benefit will be equal to your primary insurance amount. (Your primary insurance amount is also used to calculate the retirement benefit you'll receive at full retirement age.) For more information, read our article on how much are Social Security disability benefits.
If you're receiving or have received workers' comp for your injury or illness, however, your disability benefits may be limited by a worker's compensation "offset." Your combined Social Security and workers' comp benefits cannot exceed 80% of your pre-disability earnings.
Termination of Monthly Benefits
If you're granted disability insurance benefits, you must report to the SSA any changes in your medical condition, as well as any return to or increase in work, or an increase in your earnings, as these may affect your continuing eligibility. The SSA also conducts periodic reviews to determine one's continuing eligibility for disability benefits.
Do You Need a Lawyer to Get SSDI?
Hiring a Social Security lawyer can be a game-changer for some disability claimants, but is it the right move for you? The answer depends on the complexity of your case, your ability to navigate the legal system, and where you are in the application process. Only about one-third of applicants hire a lawyer for their initial application, but over 70% of those attending appeal hearings bring a lawyer with them. Why? Because the stakes—and the challenges—are higher.
Lawyers can help you build a strong case by gathering medical evidence, developing a legal theory of disability, and even cross-examining vocational experts at hearings. But if your case is strong and straightforward, and you’re confident in your ability to file a comprehensive application, you may be able to start the process yourself. To learn about hiring a lawyer, from the costs involved to the potential benefits they bring, read our article on the pros and cons of hiring a disability lawyer.
Whether or not you've already submitted a claim, our disability eligibility tool will help you determine whether you qualify for benefits.