How Does the SSA Determine If You Are Disabled?

It is a crucial question to answer if you expect to receive disability benefits from the Social Security Administration (SSA). To become eligible for financial assistance, you must have worked in positions that are covered by the Social Security Disability Insurance (SSDI) program.

Then, you have to suffer from a medical condition that qualifies you for financial assistance. If you work enough to qualify for disability benefits, as well as meet the definition of a disability, the SSA uses a five-question process to determine if you are disabled.

  • 1. Are you working?
  • 2. Is your condition "severe"?
  • 3. Is your condition found in the list of disabling conditions?
  • 4. Can you do the work you did previously?
  • 5. Can you do any other type of work?

How Does the SSA Define a Disability?

Social Security pays benefits for cases that involve total disability. This means the SSA does not approve claims that request financial assistance for a partial or short-term disability. The broadest definition that answers the question, “Am I disabled” requires you to meet the following three criteria.

  • You cannot perform work that you did before your medical condition
  • You cannot transition to another line of work because of your illness
  • Your disability has lasted or the SSA expects it to last for at least one year

The SSA has adopted rules based on working Americans having access to other types of resources to provide financial assistance during the time it takes to recover from a short-term disability. Some of the resources include insurance, personal savings, and workers’ compensation.

If you meet the SSA’s broad definition of what qualifies a person as disabled, then the federal agency moves through a series of five questions that are asked in sequential order.

For example, if you meet the criteria required for answering question number one, the SSA then moves on to question number two. If you do not meet the criteria for answering question number one, then you do not get a positive answer to the question, “Am I disabled.”

How Does the SSA Determine If You Are Disabled?

Meeting the Guidelines Established by the 5 Questions

If you meet the broadest definition of a disability, the SSA goes through a five-question process to determine if you qualify for financial assistance for suffering from a disability.

Question #1: Are You Working?

In 2024, if you earned more than $1,550 a month, the SSA typically does not consider you to be disabled.
The SSA sends your claim for disability benefits to the Disability Determination Services (DDS) that bases the answer to the first question on the number of work credits you have accumulated from your annual wages or self-employment income.

In 2024, you earn one work credit for every $1,730 you generate in wages or self-employment income. For example, if you generated $13,840 in wages or self-employment income in 2024, you accumulated eight work credits.

The number of work credits that you must accumulate to become eligible for Social Security disability benefits depends on your age at the time you became disabled.

Question #2: Is Your Condition “Severe”?

Question number two provides a simple explanation that determines what qualifies a person as disabled. Your medical condition must substantially limit your ability to complete basic job functions for a minimum of 12 consecutive months. This means you do not qualify for Social Security disability benefits if you missed work for eight consecutive months, returned to work for six months, and then missed another four months in a row.

Your employer can confirm that you missed 12 consecutive months of work by providing the SSA with timekeeping records. You should also submit copies of your bank statements that prove you did not receive income during 12 consecutive months.

Question #3: Is Your Condition Found in the List of Disabling Conditions?

The SSA publishes a medical guide called the Blue Book that lists the qualifying medical conditions for Social Security. For example, the Blue Book lists cancer as a qualifying medical condition for disability benefits under Section 13.00.

If the SSA lists your medical condition in the Blue Book, you have passed the first test that answers the question, “Am I disabled.”

The second test involves meeting the severity of symptoms criteria that accompanies every qualifying medical condition. You must meet the minimum threshold established for the symptoms that are associated with a certain illness.

Diagnostic test results and other types of medical data can verify that you meet the symptoms criteria spelled out in the Blue Book.

Question #4: Can You Do the Work You Did Previously?

With the 4th question, the SSA wants to know if your disability prevents you from completing the standard job functions that are required by your job.

Undergoing a Residual Functional Capacity (RFC) assessment can help the SSA determine whether you can continue working in your current position or whether you need to transition into another career.

An RFC assessment is primarily used by the SSA to measure your ability to work. A physician from the SSA and/or your doctor put you through a series of mental and physical tests to discover whether you have any professional limitations.

For our cancer example, this means an RFC might include one or more tests that determine your stamina. One of the most prevalent symptoms of cancer that inhibit stamina is the side effects of going through radiation and/or chemotherapy treatments.

Question #5: Can You Do Any Other Type of Work?

By now, you should have the answer to the question, “How do you know if you are disabled.” Step five in the five-question process determines whether your disability prevents you from doing any other type of work.

Once again, your RFC assessment should reveal if you have the ability to move into a different job. If stamina is an issue because of the side effects of cancer treatments, perhaps an RFC assessment can uncover a job that allows you to remain sitting for prolonged periods during a workday.

Schedule a Free Case Evaluation

Improve your chances of getting a disability claim approved by the SSA by working with a Social Security disability attorney. Your
lawyer can help you gather and organize the medical documents you need to file a successful claim.

Most Social Security attorneys schedule a free case evaluation with clients to determine the best course of legal action that ultimately answers the question, “Am I disabled.”

Additional Resources