How SSDI benefits are determined

July 26, 2010 · by rosenblumlawfirm · in

The Social Security Administration (SSA) appoints a special office called the Disability Determination Services to review claims for Social Security Disability Insurance (SSDI) benefits. Applications will go to the office in the state where the applicant lives. The office uses a five step process to determine if benefits will be granted.

These five steps are as follows:
1. If the applicant is currently working and earning an income over a certain amount, the office generally does not consider them disabled. If they are working but earning less than the average amount for their geographic area, the office will closely consider at their application. The average earnings dollar amounts change every year with the SSA based upon actual reported incomes.

2. The office will determine if the applicant’s medical condition is severe enough to prevent them from working for at least one year by limiting common work activities such as walking, sitting, lifting, or using memory skills; this is how the SSA defines a disability.

3. The agency will consult the SSA’s official List of Impairments to see if the applicant’s medical condition is listed. Examples of impairments can fall within major categories including musculoskeletal impairments, respiratory problems, mental disorders, immune system disorders, skin diseases, or cardiovascular problems. If the applicant’s condition is not on the list, this is not an automatic disqualification for the applicant; instead, the agency will decide if the condition is as severe as those listed.

4. The state office will look at the type of work the applicant was doing before the alleged disability and whether it can be performed again, even with the medical condition.

5. If the applicant cannot do the type of work they did before, the agency will determine if there are other types of work available based upon the applicant’s age, education, other skills, and work experience that would allow the applicant to earn a reasonable living wage.

If the application makes it through all five steps, the state agency will generally find that the applicant is disabled and eligible for SSDI benefits if there are no types of work they can do.