Social Security offers two types of benefits for disabled individuals: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Each program provides different benefits, but the determination of disability is the same.
In order to be eligible for either SSDI or SSI, you must be considered to be a disabled individual. The same standards and rules are used to determine disability under both benefit programs. In general terms, a disabled individual is 1) unable to return to his prior work; 2) unable to learn or adapt to a new kind of work; and, 3) the disabling medical condition is expected to last more than one year or result in death.
There is a five step process to determine disability. The first step is to determine if you are working. Generally if you are working at the time of your application, SSA will not find you to be disabled. Second, SSA will evaluate your medical conditions to determine if you have a severe impairment. A severe impairment is a condition that significantly limits your ability to perform some life activity – including sitting, standing, walking and remembering – for at least one year. In evaluating your medical condition, SSA will look at information provided by your doctors, you, and other people who know your condition and its effect on you. It is important that you see your doctor regularly and have updated information for Social Security.
If your condition is considered severe, the next step is to determine if you automatically qualify for benefits because your condition is included in the List of Impairments. The List of Impairments is a collection of conditions created by the SSA that are so severe that they warrant an automatic finding of disability. If your condition meets or equals a condition included in the listings, you will be found disabled. A majority of applicants do not receive benefits at this stage and not meeting a listing condition does not preclude receiving benefits.
If your condition does not meet or equal a condition on the listing, SSA moves to the fourth step and considers your past relevant work. Generally at this stage, SSA looks back to the fifteen years prior to your alleged date of disability, considering the type of work you performed and determine if, given your conditions, you are able to return to that type of work. If it is decided that you cannot return to previous work, SSA will determine if you can do any work. At this final step, SSA will consider your medical conditions, restrictions, age, education, past work experience and any special skills you have that may be used in other work. If your age, education, past work experience and medical conditions prevent you from working in any other type of job, you will be found disabled.
Keep in mind that Social Security does not consider only if you can do your past work, but also if you can find new work. This can include work that you need retraining to perform or that may be “less” than you feel you are worthy of. In determining whether there are other types of work you could perform given your age, education and experience, Social Security generally seeks the testimony of a vocational expert during the hearing process. For that reason, it is recommended that you have an attorney represent you during the hearing process.