PLEASE NOTE: The well-being of our clients is of the utmost importance to us. To protect your safety in response to the threats of the novel coronavirus (COVID-19), we are offering our clients the ability to speak with us via telephone conference or through video conferencing. Please call our office to discuss your options. We are here to help you in these unusual and difficult times.

How does SSA decide if my disability qualifies for benefits?

If you are considering applying for Social Security Disability benefits in Florida, you may be wondering how SSA determines whether your ailment qualifies. There are two types of disability programs under the SSA — Social Security disability insurance and Supplemental Security Income. They both use the same definition of disability. 

Understanding this definition and the process of determination can help you file the most favorable claim. 

Disability definition

To the SSA, disability is “the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” For adults, this means that your ailment will need to be severe enough to prevent you from working or retaining employment. 

The definition explicitly includes the phrase “medically determinable” to signify that SSA requires documentation demonstrating your impairment and that a doctor’s opinion or statement is insufficient. SSA suggests having evidence such as test results, medical records and scans. 

In some cases, SSA will also consider your lifestyle to determine whether an ailment prevents you from working. For example, if you file claiming that you are in pain and cannot work and then enter physical fitness competitions, SSA may reconsider your eligibility. Similarly, if you claim a psychological impairment and then drink excessive amounts of alcohol, the SSA may determine that your behavior caused or exacerbated your impairment. 

Listing of impairments

To determine what does and does not qualify, the SSA has established a list of impairments and categorized them by areas of the body. This list is not an exhaustive list of impairments they will consider, but anything you wish to claim will need to be comparable or at least as severe as those the list names. 

The listing of impairments includes the more common disabilities that prevent a person from working. Most of these are permanent or terminal ailments, but permanency is not necessarily a requirement. If you wish to file for disability for a nonpermanent impairment, you will need to provide sufficient documentation to demonstrate that the ailment has lasted at least one year — or that medical professionals expect it to last at least one year.