What criteria must a person meet to qualify for SSDI benefits?

To qualify for SSDI benefits, a person must suffer from a qualifying disabling condition, be incapable of substantial work and have adequate prior earnings.

Many people in Hackensack live with persistent or debilitating medical conditions that seriously affect their personal lives, finances and ability to work. According to the 2010 United States Census, 6.5 percent of New Jersey residents who are under age 65 live with disabilities. With older adults factored in, the state's proportion of disabled residents may be even higher.

Based on their conditions and associated restrictions, a number of these adults may qualify for monthly Social Security Disability Insurance benefits. However, to obtain these benefits, these individuals must first show that they meet several specific criteria regarding their earnings, employment and health.

Adequate past earnings

SSDI benefits are only available to people who have earned enough credits based on prior income that they paid Social Security taxes on. A person's age, along with the age at which he or she became disabled, helps determine how many credits she or he needs. Some people alternately may qualify for SSDI benefits based on the earnings record of a spouse or former spouse who receives SSDI benefits.

People who do not have an adequate earnings history cannot collect SSDI benefits, though they may be eligible to receive Supplemental Security Income instead. These benefits are available to disabled individuals who have limited income and resources.

Reduced working capacity

For a person to be considered disabled under Social Security's criteria, he or she must suffer from a condition that is severe enough to interfere with his or her work. People who can still perform work that they did in the past cannot receive SSDI benefits. This is also true of people who reasonably could be expected to successfully take up new types of work. People who earn monthly income over a fixed threshold, which is $1,130 in 2016, usually are ineligible to receive SSDI benefits.

Significant disablement

People who meet the above criteria must still prove that they meet Social Security's definition of "disabled." SSDI benefits are not awarded to people who have partial or temporary disabilities; instead, a disability must be total and expected to result in death or persist for at least 12 months. People making claims for SSDI benefits may take several approaches to show that a condition is disabling, including:

  • Documenting a diagnosis of a condition that appears on Social Security's Compassionate Allowances list. These conditions are so severe that they almost always qualify as disabling.
  • Providing medical evidence of a condition that appears in Social Security's "Blue Book" of disabling conditions. People who suffer from a condition listed in the book and meet the associated medical criteria may qualify for benefits if they meet Social Security's other requirements.
  • Demonstrating that a condition is equal in severity to a "Blue Book" condition.

If a disability does not meet any of the above criteria, a person might still be able to qualify for benefits by providing evidence that the condition precludes her or him from performing any type of gainful work.

Seek qualified guidance

Unfortunately, proving that all of these criteria are met can be challenging. In 2010, the last year with available data, more than half of SSDI claims were denied based on medical reasons, according to a report from the SSA. Over half of these denials were made because applicants did not succeed in adequately documenting the seriousness of the disability or its adverse effects on their ability to work.

To reduce the risk of this outcome, anyone who is preparing to apply for SSDI benefits should consider partnering with an attorney to craft a more compelling and credible claim.