of Health) to make the determination as to whether an individual is disabled. The SSA has contracted with the state Disability Determination Service (DDS) (in Florida, the Office of Disability Determinations (under the Dept. Once your application is complete and filed with the SSA, it usually takes one to five (1-5) months for a decision to be made or your initial application. The initial application can be completed at the local SSA office, by phone, or online at Information will be needed regarding your medical history, names and addresses of doctors and hospitals, work history and the names of employers for the past fifteen years, resources (assistance, income, assets, etc.), and personal information (including social security numbers of you and your dependents, dates and locations of marriages and divorces). This is called the Initial Application stage. The first step is to apply for SSDI and/or SSI benefits. Here the Social Security Regulations make it easier to qualify for benefits if the individual is older, has less education and hasn’t worked in skilled employment in the past. Is the claimant capable of performing other work (that exists in the national economy) that is within the claimant’s RFC given their age, education and transferable work skills. Past relevant work is work that they performed in the last fifteen years. If the individual’s medial condition meets the criterion, then the person is found disabled without further inquiry and Steps 4 and 5 are not considered.Ĭonsidering the claimant’s “residual functional capacity” or RFC (what the person can do despite their medical impairments) are they capable of performing any of their past relevant work. Has the impairment lasted or is expected to last for 12 months or more?ĭoes the claimant have an impairment that meets or medically equals the “listing of impairments”? The listing of impairments is a list of diseases and medical conditions and criteria of severity for each. For 2023 the threshold for SGA is $1,470 for non-blind individuals and $2,460 for blind individuals.ĭoes the claimant have a severe impairment? This is an inquiry into whether the individual has a medically determinable impairment or combination of impairments that is “severe” in that it significantly limits an individual’s ability to perform basic work activities. Is the individual engaging in “substantial gainful activity” (SGA)? This is an evaluation as to whether the claimant is actually working by earning wages or performing self-employment and whether these wages exceed a certain threshold set by the SSA on an annual basis. The five Steps listed below are what the Social Security Administration (or eventually the Administrative Law Judge) will use to determine whether an individual is in fact disabled: §423 (d)(1)(A)) The Social Security Regulations set forth a five step sequential evaluation process to determine whether an individual is in fact disabled. The Social Security Act defines “disability” as the inability “to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” (42 U.S.C. Benefits can be awarded retroactively for up to one year prior to the application. Entitlement to SSDI benefits begin five full (5) months after the onset of disability and SSDI recipients become eligible for Medicare twenty-four (24) months after their date of entitlement. Generally, you need one quarter of coverage for each calendar year after you turned 21 years of age ( For more information and exceptions, click here.)Īdditionally, you will need to have 20 quarters of coverage during the 40 quarters directly prior to your onset of disability. Your age at the date of your disability will determine the amount of credits you will need to be eligible for disability. If you have earned enough “work credits” (also known as quarters of coverage) you may be eligible to receive SSDI benefits. Benefits are paid out of the Social Security Trust Fund. SSDI is a payroll-tax funded insurance program that provides monthly income and Medicare insurance benefits to people who can no longer work due to a medical disability that lasts or is expected to last for over twelve months.
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