Qualifying for SSDI requires meeting both work history requirements demonstrating you've paid into Social Security and medical requirements showing your condition prevents substantial work. Understanding these eligibility criteria helps you evaluate whether SSDI is the right program for your situation and how to present your case effectively.
Work Credit Requirements
SSDI is based on your work history and Social Security tax contributions. To qualify, you need sufficient work credits earned through paying Social Security taxes on wages or self-employment income. Most workers need 40 credits, with a maximum of four credits earnable per year, meaning 10 years of work. However, younger workers may qualify with fewer credits based on their age at disability onset.
Recent work requirements also apply. Generally, you must have worked five of the last ten years before becoming disabled, though this requirement is reduced for younger workers. Someone who worked many years ago but not recently may have enough total credits but fail the recent work test.
The Medical Definition of Disability
Social Security's disability definition requires inability to engage in substantial gainful activity due to a medically determinable impairment expected to last at least 12 months or result in death. Substantial gainful activity means earning above a specified monthly amount through work. Medically determinable means objective medical evidence establishes the condition's existence.
The sequential evaluation process determines disability through five steps. First, are you working at substantial gainful activity levels? Second, do you have a severe impairment significantly limiting basic work activities? Third, does your condition meet or equal listed impairments automatically qualifying for benefits? Fourth, can you perform your past relevant work? Fifth, can you adjust to other work that exists in significant numbers nationally?
Listed Impairments
Social Security maintains listings of impairments that automatically qualify for benefits when medical evidence meets specific criteria. Listings cover conditions across body systems including musculoskeletal, cardiovascular, respiratory, neurological, and mental disorders. Meeting a listing provides a more certain path to approval than relying on functional assessments.
Listings have specific requirements including diagnostic criteria, severity thresholds, and duration requirements. Simply having a listed diagnosis isn't enough if your condition doesn't meet the listing's detailed criteria. Understanding the listings relevant to your conditions helps ensure medical records document the required findings.
Functional Capacity Evaluation
When conditions don't meet listings, Social Security evaluates residual functional capacity, meaning what you can still do despite your limitations. This assessment considers physical abilities like sitting, standing, walking, lifting, and carrying, as well as mental abilities like understanding, remembering, concentrating, and interacting with others.
Your residual functional capacity is compared to the demands of your past work and other jobs to determine whether substantial gainful activity is possible. Age, education, and work experience factor into whether you can adjust to different work. Older workers with limited education and physical labor backgrounds face easier standards than younger, educated workers.
Common Qualifying Conditions
Many conditions can qualify for SSDI when severe enough, including musculoskeletal disorders like severe arthritis and back problems, cardiovascular conditions including heart failure, respiratory diseases, cancer, neurological disorders like multiple sclerosis, and mental health conditions including depression, anxiety, and schizophrenia. Combinations of conditions that individually might not qualify can together establish disability.