Qualifying for Disability: Everything You Should Know

When your injury or condition makes it too hard to work, disability benefits are your legal right.

But the eligibility requirements are complicated — and some people put off applying because they’re unsure if they qualify.

This article explains everything you need to know about Social Security Disability. We’ll explain which programs you might be eligible for, the technical and medical requirements for each, and the factors that increase your chances of approval.

Understand which disability program you qualify for

When people say they’re “going on disability” — they usually mean Social Security Disability Insurance. Almost 10 million Americans take advantage of the program. But there are a few other programs — some federal, some state, and some private — that you may qualify for if you’re unable to work.

A quick breakdown:

• SSDI (Social Security Disability Insurance) is for Americans who have worked and paid into social security. They’re like getting your retirement benefits ahead of time: You’ll qualify for free Medicare and the weekly payments that you would have started receiving at 67.

• SSI (Supplemental Security Income) is for Americans who don’t meet the work history requirements of SSDI, and have very little income and assets. SSI is needs-based, and usually pays out less per month. It also grants you Medicaid.

• Private, state, and VA insurance: Only 5 states have their own insurance programs — California, Hawaii, New Jersey, New York and Rhode Island. They generally only support you for a shorter period of time. Your employer may have also offered disability insurance. To qualify, you would have had to pay into the program before becoming disabled. VA insurance is for military veterans.

Most Americans qualify and apply for SSDI — but you can apply for SSI and SSDI at the same time. That’s usually a good bet if you have a limited work history and could benefit from faster access to healthcare (there’s a waiting period for Medicare with SSDI, there’s no waiting period for Medicaid with SSI).

Fewer Americans qualify for private, state, and VA insurance. But we’ve done a more comprehensive write up of what benefits you should apply for here, if you live in a qualifying state, are a veteran, or have an existing disability insurance policy.

From here on out, we’ll be discussing federal disability programs — SSI, and SSDI. They’re the most common programs people qualify for, you can apply for them on the same application, and they share some eligibility requirements.

Technical requirements for SSDI

To meet the non-medical requirements for SSDI, you must:

• Have earned a set amount of “work credits.” Most people have enough credits if they’ve worked, and paid into Social Security, for five out of the last 10 years.

• Be making less than $1,550 per month through work. You can have other means of income (such as real estate or investments). But if you make more than $1,550, the Social Security Administration considers it “Substantially Gainful Activity.” At that point, they’ll assume you're healthy enough to be working more.

• Be under 67 years old. When you turn 67, your SSDI benefits will become your retirement benefits.

The most complex part of the process here is understanding your work credits. If you’re not sure if you’ve worked enough, it’s easy to check on SSA.gov.

You’ll need to create an account. Then you’ll be able to see the number of work credits you have, and your expected monthly disability amount.

To check:

• Visit SSA.gov

• Scroll down to “learn about my account” next to “mySocialSecurity”

• Create an account using your Social Security number (SSN). This takes a few steps and authentication.

• Scroll down to the section titled “Disability”

Technical requirements for SSI

To meet the non-medical requirements for SSI, you must:

• Have personal or retirement assets less than $2,000 for single applicants and $3,000 for married individuals.

• Have little to no personal income, typically less than $1,000 per month.

The most complex requirement here involves understanding what “assets” are. Some things you own won’t count towards the requirements (the house and the property it sits on, your first car). Some don’t count towards the requirement limits, but will be deducted from your overall SSI check (food stamps, or benefits from other programs).

The SSI has a full list of resources that do, and do not, count as assets worth exploring, if you’re considering applying for SSI.

Medical requirements for SSDI and SSI

Beyond the technical criteria for SSDI and SSI, there are shared medical requirements that are critical for your eligibility. Most application rejections are due to lack of medical evidence.

For either program, your condition has to last, or be expected to last, at least a year. It also has to be sufficiently disabling — meaning it has to be severe enough to prevent you from working.

What it means to be “prevented from working” depends on your age. The SSA feels, if you’re under 50, you could be trained to do other work. Because of that, if you’re under 50, you’ll have to prove to the government you’re too sick to do any possible job.

If you’re over 50, the SSA thinks it’d be harder for you to transition to new work. You’ll only have to prove that you’re unable to work jobs in your field — or like ones you’ve done in the past. More on disability eligibility after 50 here.

Conditions that qualify for social security disability

Any condition can qualify for social security disability, as long as it’s sufficiently severe enough to keep you from working. We’ve helped clients get disability benefits for a wide range of different conditions — from diabetes, to Crohn’s, to depression, to cancer.

The SSA has a long “list of impairments” that breaks down many of the conditions that can qualify. They also list the medical evidence they look at to determine whether or not your instance of that condition is severe enough to be eligible. Many people who apply struggle with multiple conditions, which together, make working impossible.

We did a comprehensive write up of how the SSA evaluates each type of medical condition here. But in general, the conditions fall into a few categories:

• Mental disorders (34.6% of disability recipients): Anxiety, depression, Autism spectrum disorders, Bipolar disorders, developmental disorders, Obsessive-compulsive disorders, eating disorders, etc.

• Musculoskeletal disorders (30% of disability recipients): Back pain, knee pain, rheumatoid arthritis, etc.

• Special senses and speech disorders (9.9% of disability recipients): Blindness, deafness, vertigo, etc. 

• Respiratory conditions (20% of disability recipients): Asthma, COPD, cystic fibrosis, emphysema, chronic pulmonary hypertension, etc.

• Cardiovascular system conditions (6.8% of disability recipients): Aneuryisms, congestive heart failure, coronary artery disease, POTS, etc.

• Digestive system disorders (1.4% of disability recipients): Crohn’s disease, chronic hepatitis, chronic liver disease, Ulcerative colitis, inflammatory bowel disease, etc.

• Genitourinary Disorders (1.7% of disability recipients): Chronic kidney disease, renal failure, etc. 

• Hematological Disorders (.3% of disability recipients): Aplastic anemia, sickle cell disease, Myelodysplastic syndromes, Thalassemia, etc.

• Skin Disorders (.2% of disability recipients): Burns, psoriasis, bullous diseases, ichthyosis, etc. 

• Endocrine Disorders (2.4% of disability recipients): Diabetes, parathyroid gland disorders, hyperglycemia, adrenal gland disorders, etc.

• Cancer (Malignant Neoplastic Diseases) (2.9% of disability recipients): Breast cancer, Leukemia, Lymphoma, lung cancer, stomach cancer, etc.

• Neurological Disorders: Epilepsy, multiple sclerosis, narcolepsy, stroke, traumatic brain injury, etc.

• Immune System Disorders: AIDS, Raynaud's phenomenon, polymyositis and dermatomyositis, systemic vasculitis, etc.

Injuries and infectious/parasitic diseases also qualify for benefits — depending on their severity and duration. (If you’ve been injured at work, you should also consider applying for workers’ compensation).

Conditions that automatically qualify

There are two types of medical conditions that can automatically qualify a person for disability benefits: Compassionate allowance cases and TERI (terminal illness) cases.

These conditions are deemed to be sufficiently disabling by their diagnosis alone, and if you have one, you may be eligible for fast-tracked benefits (though you’ll still have to meet the technical program requirements).

Some examples of compassionate allowance conditions include Coffin-Lowry syndrome, early-onset Alzheimer's disease, and certain types of cancer. We’ve listed all the compassionate allowance conditions for 2022 here. TERI conditions often overlap with compassionate allowance conditions, and require medical evidence that your condition is terminal.

If you have one of these conditions, or your condition is terminal — you likely don’t need to work with a lawyer. It’s in your best interest to call your local DDS after you’ve submitted your application, letting them know you have a compassionate allowance or TERI case. They’ll often prioritize your application.

Other factors that impact your chances of being approved for disability

Even if you meet all of the eligibility requirements — proving to the government that you qualify can be hard. You’ll need the right medical evidence, and you’ll need to answer the application questions thoroughly. While these aren’t strict rules, they impact your chances of approval.

Here are a few factors that can change your odds of success: 

Age: If you’re over 50, you have less to prove. Rather than having to demonstrate your condition prevents you from doing any job — you only have to prove it prevents you from doing your current, or recent, jobs.

If you’re younger, it can be harder. If you’ve worked in construction your whole life, but a back injury and COPD make that labor too grueling — you’ll have to explain to the SSA why you couldn’t work as a cashier. Or a desk job. This isn’t impossible, but requires more consideration than if you’re over 50.

Treatment history: Medical evidence is crucial for disability application success. Having regular treatment, from a specialist, can go a long way towards showing the SSA the impact of your condition. The more frequent, and the more recent, the better.

This is particularly true if you’re applying with a mental health condition. While physical disorders often come with set ways to measure severity (like x-rays, MRIs, and blood tests) — mental health cases are more personal to the individual. Your best medical evidence will be from your patient records — notes from your psychiatrist and your psychologist.

Current work: The SSA thinks of SSI and SSDI as programs explicitly meant for people who are too sick to work. If you’re working close to the sustainable gainful activity limits — they may be more skeptical. A hearing judge might ask why you couldn’t work a few more hours, or take another shift. We recommend not working, or working well under the $1,550-per-month-limit, while applying. More on working and benefits here.

Having a lawyer: Government studies show that you’re three times more likely to win benefits with a lawyer. This is helpful at the application stage; your lawyer can either complete your application for you, or advise you closely on how to complete it.

And it’s critical at the appeal or hearing stage; your lawyer can cross-examine government witnesses and prep you for the judge’s questions. 83% of people have legal representation at the hearing stage.

Lawyers charge the same amount whether you bring them on earlier rather than later, and they charge you nothing at all unless they win your case. Then they take a percentage of your first disability check.

Finding the right lawyer can be daunting. At Atticus, we take out all the guesswork — matching dozens of clients a day with a vetted, top-tier lawyer from our network. We can also provide personalized legal advice, and our services are always free. To get started, take our 2-minute quiz.