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How Social Security Makes Eligibility Determinations

Social Security Disability is available only to individuals who are “totally disabled.”  Federal law has a very strict definition of disability, paying benefits only to those people who cannot work because they have a medical condition that is expected to last at least one year or result in death.

Adult disability is evaluated under a five step process, which considers your medical condition, any work you are currently doing, and the effect that your condition has on your ability to work.  The five criteria are:

·          Are you currently working? 

If you are and your earnings are more than a certain amount each month, you will generally not be able to collect benefits.  In 2008, that amount was $1,570/month for blind individuals and $940/month for non-blind.

If you are not working, or your monthly earnings are below the current amount, your application proceeds to the next step.

·          Is your medical condition “severe”? 

In order to be eligible for benefits, your medical condition must significantly limit your ability to do basic work activities (walking, sitting, remembering) for at least one year. 

·          Is your medical condition on the List of Impairments? 

Some medical conditions are so severe that they automatically qualify for benefits.  These conditions are contained in the List of Impairments.  This list is broken down into Adult Listings and Childhood Listings.

If your medical condition is not on the List of Impairments, the state agency will continue to consider your application for benefits on a case-by-case basis.

·          Can you do the work you did before?  The next question is whether your medical condition prevents you from being able to perform the same work you did before.  If it does not prevent you from doing so, the agency will decide that you are not disabled.  If it does prevent you from doing the same work you did before, the agency proceeds to the final step.

·          Is there another type of work you could perform?  The final step is to evaluate your medical condition, age, education, past work experience, and any other skills you possess to determine whether you could pursue another line of work.  If you cannot do other work, the agency will determine that you are, in fact, disabled.  However, if there is another line of work you could pursue, you will not be eligible for Social Security Disability Benefits.

Disability determinations are made by state agencies.  The New York Social Security department can be found here.