Social Security Disability eligibility is based upon your employment history and the nature and extent of your disability. To qualify, you must have sufficient work credits and a disability that prevents you from continuing your past work or other types of employment.
Work Credits and Social Security Disability Eligibility
SSA requires applicants to have sufficient work credits, measured as “quarters of coverage.” A “quarter” means being gainfully employed for a quarter of a year. Generally, a person must have 40 quarters of coverage to be eligible. Special rules may apply if a person becomes disabled before he or she earns 40 credits. The number of work credits varies between six for those between the ages of 21 and 24 and up to 40 for those aged 62.
In the past, a person would actually have to earn wages, or self-employment income, in each quarter to obtain a quarter of coverage. This is no longer the case: SSA now has a minimum earnings requirement to earn a quarter of coverage, but it can be earned at any time during the year. For 2013, the minimum earnings needed to earn a quarter of coverage are $1,160. A person can earn a maximum of four quarters per year.
For example, Worker A earns $10,000 in 2013, but all earnings come in the first half of the year. Worker A will receive four quarters of coverage, even though she only earned wages in the first half of the year. However, she can only receive four quarters of coverage annually.
Not only must a person have an accumulation of work credits, some of the work credits must have been recent. SSA has a test to determine the person’s “date last insured.” In general terms, the applicant must have obtained at least 20 work credits in the past 10 years prior to applying for disability.
Social Security Disability Eligibility and Physical or Mental Disability
Social Security will pay benefits when an eligible applicant is prevented from working due to a medical condition anticipated to be at least one year in duration or result in death. Social Security does not pay temporary or partial disability.
The disability must be severe enough to not only prevent the individual from performing past work, but any other work for which the applicant may be qualified to perform and which exists in the national economy. Your SSDI eligibility also depends on your age, experience, skill level and your physical or mental condition.
For example, Worker A is 35 years old and has worked as a roofer his entire life. He suffers a back injury which prevents him from lifting more than 20 lbs. and must avoid repeated bending and stooping. Worker A probably can no longer perform his past work as a roofer, but he may be employed in less physically demanding occupations. Without more evidence of a disability besides the back injury, he may be denied SSDI.
To determine whether a person has a sufficient disability, SSA has a list of common physical illnesses and diseases and sets a severity level for each. The applicant’s disability and physical symptoms will be compared to those on SSA’s list of impairments.
If the disability of the applicant fails to match one of SSA’s listed impairments, it will usually require the applicant to be examined by a physician to determine his or her residual functional capacity. This means they will look at all disabilities of the applicant and determine what they work he or she can perform, if any. SSA will be required to consider all disabilities of the individual. Sometimes, several minor disabilities in combination may be enough for a determination of “disabled.”
For physical impairments, SSA employs a “grid,” or table, of an individual’s work restrictions, along with his or her age and work experience to determine Social Security Disability eligibility. Older workers with an unskilled work level may find their application granted easier than a younger individual with a higher education or skill level.
If the grid does not apply and the individual is not able to return to previous work, SSA will determine whether there are other jobs the person may be capable of performing. Often, the jobs listed in this category are of a low physical exertion and relatively low skill level.
Consider Qualified Legal Assistance
As you can see, determining and establishing SSDI eligibility can entail a complex application process. A consultation with a qualified and experienced SSDI attorney can often mean the difference between a successful and unsuccessful application.