Denied SSDI or SSI–Do I Qualify?
Five-Step Evaluation Process for SSDI or SSI

Applying for Social Security Disability Income (SSDI) and Supplemental Security Income (SSI)

To apply for Social Security Disability Benefits – SSDI and/or SSI, you must contact the Social Security Administration (SSA).  You can do this by telephone by calling (800)772-1213, over the internet by going to www.ssa.gov, in person at your local Social Security office, or by mail.  Once you have applied for social security disability benefits, it usually takes approximately 120 days for the Social Security Administration to notify you of whether you were approved or denied Social Security Disability (SSDI) or Supplemental Security Income (SSI).

 
Social Security Disability Income (SSDI) and Supplemental Security Income (SSI) must be proven in the same way.  However, there are differences between SSDI and SSI.

 

SSDI is based on the amount you have paid into the system and does not take into account any of your assets.  To qualify for SSDI, you must be disabled, have worked and paid into the system 20 out of last 40 quarters immediately preceding your onset date of disability.

 

To qualify for SSI payments, you must be disabled, and your assets cannot be greater than $2,000 for an individual or $3,000 if you are married.   If you have assets in excess of these amounts, even if you are disabled, you are not entitled to SSI payments.

 

The Social Security Rulings have established a five step sequential evaluation process that is binding on the Social Security Administration and the Administrative Law Judge.  To decide whether you are disabled, the following step-by-step process must be followed:    

 

 Step 1: Is the Claimant performing Substantial Gainful Activity?

      Substantial Gainful Activity (SGA) is defined as work that involves significant and productive physical or mental duties and that is done or intended to be done for pay or profit. (See 20 CFR Section 404.1510).  In 2011, the numerical calculation for Substantial Gainful Activity (SGA) is earnings or wages of no more than $1,000 per month.  If you are working in 2011 and your earnings average more than $1,000 a month, you generally cannot be considered disabled.

If you are not working, you are not performing Substantial Gainful Activity and you are able to move forward to Step 2.

Step 2:   Is the Claimant’s Impairment Severe?

Your condition must interfere with basic work-related activities for your claim to be considered.  If it does not, you will not be found disabled by the Social Security Administration.  If your condition does interfere with basic work-related activities, we go to Step 3 

 

Step 3.      Do any of your Impairments meet or Equal a Listed Impairment?

      The Listings describe impairments that prevent you from doing any gainful activity.  These impairments are so severe that there doesn’t need to be any consideration of the vocational elements, such as age, education, or past work experience.  For each of the major body systems, the social security administration maintains a list of medical conditions that are so severe they automatically mean that you are disabled.  If your condition is not on the list, a decision needs to be made if the condition is of equal severity to a medical condition that is on the list.  If it is, the finding should be that you are disabled.  If it is not, you must proceed to Step 4

 Step 4.      Are you able to perform your past relevant work?

       If your condition is severe but not at the same or equal level of severity as a medical condition on the list, then it must be determined if it interferes with your ability to do the work you did previously.  If it does not, and you are able to do your past relevant work, then your claim will be denied.  If it does prevent you from performing your past relevant work, then you must proceed to Step 5. 

Step 5.      Can you perform any other type of substantial gainful activity existing in significant numbers in the national economy? 

      At this step, the burden shifts to the Social Security Administration to establish that you can perform other work.  If you cannot do the work you did in the past, the Social Security Administration must determine if you can perform any type of other substantial work.  The Social Security Administration or Administrative Law Judge, must consider your medical conditions,your age, education, past work experience, any transferable skills you may have, and your maximum sustained work capability.  If you cannot adjust to other work, your claim will be approved.  If you can adjust to other work, your claim will be denied.

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