To obtain Social Security disability benefits through the Social Security Administration (SSA), you must undergo a long, confusing process. People with severe impairments may have difficulty qualifying for benefits because of the SSA's requirements.
To qualify for disability benefits, an applicant must prove they are disabled or suffer from an impairment that limits their ability to function and cannot work due to their impairment. While it may sound straightforward, the SSA uses several specific definitions and criteria to determine eligibility.
When it comes to qualifying for disability benefits, rules for older applicants are a bit different. Because they are less likely to be able to perform a new type of work, it is sometimes easier for individuals to qualify for benefits, even though they must still go through the basic five-step analysis to demonstrate their disability.
The Process to Determine Disability
The Social Security Administration uses a five-step process to determine eligibility for disability benefits. Here are the factors that are taken into account during this process:
- Do you engage in a substantial gainful activity (SGA)?
- Have you been diagnosed with a severe impairment?
- Is your condition listed in the SSA's list of disabling impairments or at least equal in severity to a listed condition?
- Are you capable of doing the work you did previously?
- If not, can you do any other kind of work?
Step One
The first step is to assess whether you are working. You cannot receive disability benefits if you are gainfully employed. Social Security examines whether you perform work at "SGA" levels to determine if you qualify for Social Security benefits. This is the amount of money Social Security sets each month. Those who are legally blind in 2022 will receive $2260 as their SGA payment. However, individuals who are not blind will be eligible to receive $1350 a month in SGA. In other words, that means a person who works part-time and earns less than the SGA amount can still qualify for disability benefits.
You need to remember that gross income is your take-home pay before tax and other deductions. For example, if you work at a job that pays $10.00 an hour, you cannot work more than 28 hours a week. You can still be considered able to do more with part-time employment even if you don't meet Social Security's "SGA" amounts.
Step Two
Once the SSA determines that the applicant meets this qualification, it will determine if the applicant suffers from a severe physical or mental condition. To apply, you must demonstrate that you have a disability that has lasted or will last for at least 12 months or will cause your death. If you cannot work, your impairment must have a more significant impact than a minor one.
However, it is just a screening process - Social Security simply checks to see if you have a medical condition worth exploring further. Social Security will not find you disabled just because you have been deemed a "severe" impairment at Step Two.
Step Three
In the third step, the Social Security Administration evaluates the degree of your impairment against the SSA's list of impairments. When a person meets the specific requirements of a listed impairment, the SSA determines they are entitled to benefits. Social Security does not need to consider their work history or whether they can do other work. Typically, people do not meet or equal one of these impairments, so the third and fourth steps are skipped.
If you do not meet a Listing, Social Security determines your Residual Functional Capacity (RFC), which is the maximum amount of work you will be able to do considering your impairment or combination of impairments. Your RFC will be assessed by SSA after reviewing your medical records, considering your subjective reports, and consulting your physicians.
Step Four
At Step Four of the hiring process, SSA will decide whether these limitations prevent you from performing your past relevant work, including any work you may have completed in the past 15 years at SGA levels, or long enough to learn the job.
Step Five
SSA's duty only shifts to it at the fifth and final step of determining whether you can do other types of work available in significant numbers in the national economy if Social Security finds that you cannot do your previous work. The SSA will consider your age, education, past work experience, and transferrable skills when evaluating your qualifications. Your claim for disability benefits will be approved if you cannot do any other substantial work.
How the Process May Change After Age 50
In Step Five, there will be a change on whether you can do other work if you are 50 years old or older. The SSA may apply different guidelines during the last stage of the process when the agency determines if an applicant can perform other types of work. These are called the Medical-Vocational Guidelines or GRID rules. They are referred to as “Grid” rules because they are laid out in a grid format.
Under the GRID rules, for example, Social Security determines you can still do sedentary (desk work) work between 50 and 54. If you cannot perform the work you did before, you may be found disabled. In addition, you need to demonstrate that your past work experience did not lend itself to sedentary jobs that are semi-skilled or skilled (jobs that require some training).
Therefore, even though Social Security believes you could still perform sedentary work, you will receive disability benefits since the regulations acknowledge that mature adults with significant medical impairments have difficulty adapting to new work environments. You will not be found disabled under this rule if you previously performed sedentary work and can still perform this work. However, you will still need to demonstrate that you cannot perform that work.
Similarly, suppose you are 55 to 59 years old. You may be determined to be disabled even if Social Security grants you the light-level RFC (which generally means that you can lift 20 pounds occasionally, 10 pounds frequently, and stand and walk six hours of an eight-hour day). This means that your previous work has been more strenuous than light work and that you would not be able to transfer your skills to this type readily. In addition, once you turn 55, if you are restricted to sedentary work, you must be able to transition into "skilled" work to be considered disabled.
Older applicants can benefit from these guidelines. A disability applicant who can perform sedentary work will generally not be awarded benefits. The SSA, however, may deem a 50-year-old or older applicant disabled even if they think they are capable of light chores.
In addition to being complicated, GRID rules contain many exceptions. You can consult with a lawyer familiar with disability benefits to determine if they apply to your situation.
Applying for Social Security benefits can be an overwhelming process. If you seek SSDI benefits, check out our article about whether Social Security disability is taxable. To learn more, visit DisabilityHelp.org today!
