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Deter Disability Fraud, Disability Civil Rights Education, FAQs

What does the Social Security Administration define as a disability for insurance purposes?

What does the Social Security Administration consider a disability for insurance qualification?

The Social Security Administration (SSA) has a specific definition of disability when it comes to qualifying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. According to the SSA, an individual is considered disabled if they meet the following criteria:

  1. They cannot perform substantial gainful activity (SGA): The SSA defines SGA as work that involves significant physical or mental activities and is performed for pay or profit. If an individual’s earnings exceed a certain threshold (which is adjusted annually), the SSA typically considers them able to engage in substantial gainful activity and therefore not disabled.

  2. They have a severe medical condition: The individual’s medical condition must significantly limit their ability to perform basic work activities, such as walking, sitting, standing, lifting, or understanding and following instructions. The impairment must be expected to last for at least 12 continuous months or result in death.

  3. The impairment is listed in the SSA’s Listing of Impairments: The SSA maintains a comprehensive list of medical conditions for each major body system, known as the Listing of Impairments (also referred to as the Blue Book). If an individual’s condition meets or equals the severity level described in the specific listing, they are considered disabled. However, it’s important to note that many conditions, including ADHD, may not have a specific listing. In such cases, the SSA assesses the individual’s functional limitations and residual functional capacity (RFC) to determine disability.

  4. They cannot perform their past work or any other work: If the individual’s condition prevents them from performing the work they previously did, the SSA evaluates whether there are other types of work they could reasonably do based on their age, education, work experience, and transferable skills. If they cannot adjust to other work, they may be considered disabled.

It’s important to remember that meeting the medical criteria for a particular condition does not automatically guarantee approval for disability benefits. The SSA evaluates each case individually, taking into account the unique circumstances and medical evidence provided. Consulting with a qualified disability attorney or advocate can be beneficial in understanding the specific requirements and navigating the application process.

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