Some illnesses and conditions may automatically qualify you for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. But for most applicants, getting approved for disability benefits isn’t easy. You must prove to the Social Security Administration (SSA) that you are unable to work for at least 12 months. But how can you tell if you’re unable to work specifically due to your health problems? We’ll explain what the SSA looks for when reviewing your claim below.
Just trying to read the agency’s rules to figure out whether you qualify might give you a headache. Here, we’ll explain what “unable to work” really means in plain language that’s easier to understand.
How The SSA Decides Whether Your Disability Truly Makes You Unable to Work
1. You cannot perform the work tasks your full-time job requires for 12 continuous months
The SSA won’t approve your disability claim unless you’re unable to work for 12 months or have a terminal illness. First, the SSA looks at whether you can work on a “regular and sustained basis,” or 40 hours per week. If your condition limits your work to just a few hours or days each week, that could help your case. Essentially, working 40 hours every week (without excessive absences) is how the SSA defines “full-time employment.” So if your health problems make you unable to work whatever hours your last full-time job required, you might qualify.
Still not sure if your disability is what truly makes you unable to work? First, ask yourself:
- Can I work at a sit-down job for 40 hours every single week?
- If so, do I need any special accommodations (like being able to lie down)?
- Do I need to take frequent breaks during shifts?
- Am I mentally able to perform all my job tasks as expected?
- Has my doctor said my condition should improve or heal completely in less than a year?
Often, SSD applicants can’t hold down a full-time job for 12 months because they miss too many work shifts. People with painful disabilities may need more frequent breaks. You’ll need doctor’s notes and records to support your claim if that describes your current situation.
2. You are unable to work performing the same job tasks you once did, specifically due to your disability
Being unable to work full-time at your most recent job isn’t enough to qualify for disability benefits. You must be unable to work doing the tasks your job requires because of your disability. Plenty of factors unrelated to disability keep people from working full-time jobs for months at a time, like family obligations. Your disability must directly keep you from performing all required job tasks. Then, you need to show the SSA convincing proof that this is true in your claim paperwork.
In order to qualify for SSD benefits, you’ll need to complete a Residual Functional Capacity (RFC) Assessment. This assessment helps the SSA determine what kind of work you can do on a regular basis. (For claimants with mental health impairments, the SSA uses a mental RFC assessment instead.) You must prove that your disabling condition alone stops you from working full-time or completing your job tasks as required. The SSA may also see if any other jobs are hiring people full-time with your current limitations, experience and background. If not, your chances for approval are much higher!
3. You cannot do a substantial amount of work or find a similar job with your current limitations, education and background
You must be unable to “engage in substantial gainful activity” (SGA) to qualify for SSI or SSDI. That means the SSA looks at how much money you currently earn working each month. If you earn less than the maximum SGA amount allowed, then that’s one less hurdle to jump. The monthly SGA limit in 2021 is $1,310 for disabled claimants, $2,190 for blind applicants. If you earn less than that each month working part-time or doing odd jobs, then your claim may qualify.
4. You can’t find a similar full-time job at your age with your current limitations, education and background
If you can prove you’re unable to work full-time at the last job you had, the SSA looks for similar open positions. That’s because the SSA knows applying for disability benefits doesn’t necessarily mean “I don’t want to work.” But it might mean “I can’t find a full-time job I’m qualified for with my current training, education and limitations.” The SSA will look at your work history, whether or not you went to college, what degree you have, etc. If they decide you are capable of working full-time in any capacity, it’s unlikely you’ll qualify for benefits.
If your disability prevents you from doing your specific job, the SSA looks for similar positions in your skill range. The three skill ranges they use are:
If you previously worked in a semi-skilled or skilled job, the SSA may deny you benefits. Before that, they will determine how transferable your skills are into a different job that pays a comparable monthly wage. If you’re unable to work in any current job hiring in your area, that could help prove your case.
How Do They Decide Which People Can Find Another Job vs. Who’s Unable to Work at All?
The SSA uses a very specific set of guidelines to determine whether you can still earn enough to support yourself. They consider the requirements involved with each available position to see if they fit within your current limitations, including:
- Physical aspects – if the job requires standing, lifting, or carrying heavy objects, can you do that?
- Sensory limitations – Jobs you can do with limited hearing, range of motion or sight, for example.
- Mental aspects – Can you remember instructions that aren’t written down and handle job duties that change frequently without notice?
If you have strong job skills, the SSA wants to know. The agency especially considers skills like car repair, welding, programming, or any advanced degree if you’re age 50 or older. If you’re skilled or under 50, the SSA won’t use these “grid rules” when reviewing your SSD claim. In addition, the SSA updated its grid rules in April 2020 regarding claims from people who aren’t fluent in English. Now, the agency no longer considers an inability to communicate in English a factor in determining whether you’re unable to work. In previous years, disability applicants who had difficulty clearly writing, speaking or reading English may have had an easier time getting approved for benefits.
You May Qualify for Legal Assistance
Many SSD claims are borderline and subjective. If you miss work regularly and your first claim’s denied, you may need help proving you’re truly unable to work. Having a lawyer handle your claim is the best way to get paid the most benefits you’re owed faster. People often don’t realize this, but you’re 2x more likely to get approved on your first try if a lawyer files your disability paperwork. Our lawyers work on contingency, so you won’t pay any legal fees, ever, unless you win benefits. If you do win, you’ll only pay a small, one-time fee.
Ready to see if you may qualify? Click the button below to start your free benefits evaluation now!