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The financial challenges faced by someone with a disabling medical condition are considerable, so the federal government has established two programs to alleviate the burdens through the Social Security Administration (SSA). There are different eligibility rules under the Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) programs, but they share a common element with respect to the medical requirement. To qualify for SSDI or SSI, you must suffer from a medical condition that prevents you from working or limits you at work, and which is expected to last at least 12 months.
When your ailment is not continuous and happens infrequently, you probably have concerns about whether you will qualify for SSDI/SSI under the medical requirement. It is true that there can be pitfalls when applying for benefits under such circumstances, but you may still be eligible when you submit proper information to SSA. Plus, if you are denied at the application stage, there are still opportunities to move your claim forward through appeals. Retaining an Arizona Social Security disability attorney gives you an advantage in navigating the process, but some background is informative.
5 Criteria SSA Evaluates:
While every application is different, SSA goes through a standard analysis when reviewing your injury, ailment, or other medical condition. You should be prepared to respond and provide information regarding:
1. Your Current Work: If you are actively working and earning an income, your earnings must be below a threshold to qualify. You will not qualify if you make more than $1,470, the amount set as Substantial Gainful Activity (SGA) for 2023.
2. Severity of Your Medical Condition: Even when you do not suffer frequently or continuously from your condition, SSA will still look at its severity from the standpoint of your abilities. If you cannot lift, stand or sit for an extended time, or walk, your condition is a serious limitation on your basic work activities.
3. Blue Book Listing: SSA maintains a Listing of Impairments, which is a catalog covering a wide range of ailments and injuries to various parts of the body. If your condition meets or equals an item on the list, you are more likely to be approved for the medical requirement.
4. Your Past Work Abilities: SSA will also review whether there are other work tasks you can perform based upon jobs you held in the past. Your medical condition may be severe, but you might not be approved for benefits if you could earn a living in a position you previously held.
5. Other Skills: After looking at the jobs you had in the past, SSA will expand its review to see if there are any other jobs you can do with your medical condition.
Additional Requirements for SSDI and SSI:
Keep in mind that the medical requirement is just one area that SSA will evaluate for Social Security disability benefits. There are still criteria related to the two separate disability programs, so:
- To qualify for SSDI, you need to have a recent work history that meets SSA rules. This is because SSDI is a type of insurance program, in which you pay premiums through payroll taxes deducted from your paycheck.
- SSI is a needs-based program, so your net worth is the focus instead of work history. SSA reviews your assets and income, both of which must be below certain levels to qualify for SSI.
Stages After Applying for Social Security Disability:
Another important point about applying for SSDI or SSI benefits is that the initial application is just the beginning of the process. SSA denies many applicants, so you must move on to additional steps to pursue your rightful benefits. They include:
- Filing a Request for Reconsideration, in which SSA takes another look at your documents and determines whether the application should be approved;
- Requesting a disability hearing before SSA, a proceeding that is similar to a trial that gives you the chance to present testimony and arguments to support your position; and,
- Asking the SSA Appeals Council to review the decision handed down at the disability hearing.
To move forward with any of these options, keep in mind that you typically have a 60-day deadline.
Discuss Your Application with a Skilled Arizona SSDI/SSI Lawyer
As you can see, you may still be eligible for Social Security disability benefits even when your medical condition is somewhat inconsistent. For more information on applying for SSDI/SSI, please contact Pekas Smith: Arizona Disability Attorneys. You can call 602.892.7667 or visit us online to set up a free consultation. After reviewing your circumstances, we can explain what to expect with the process.
