Social Security Simplifies Disability Benefits Evaluations

The Social Security Administration (SSA) plays a crucial role in providing financial support to individuals who are unable to work because of a disability. The SSA delivers disability benefits through its Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) programs.

The process for evaluating and approving disability claims has traditionally been complex and rigorous, so that only those who meet specific criteria receive assistance. These strict criteria can be difficult to meet. However, the SSA has made recent changes to simplify some parts of the evaluation process for applicants.

Eligibility Criteria

To qualify for SSDI or SSI, applicants must meet stringent criteria:

• Work Credits: For SSDI, applicants must have earned sufficient work credits throughout their employment history, which involves paying Social Security taxes. The number of credits required varies depending on the applicant's age at the onset of disability.
• Medical Condition: The applicant must have a severe medical condition that significantly limits their ability to perform basic work activities. The condition must be expected to last at least one year or result in death.
• Limited Resources: SSI applicants must have no more than $2,000 in countable resources to qualify initially.

How the Evaluation Process Works

The SSA employs a five-step sequential evaluation process to determine disability.

1. Substantial Gainful Activity (SGA): The first step checks whether the applicant currently engages in SGA. If they are earning above the SGA threshold, the SSA will deny their application. (For 2024, the SGA threshold is $1,550 per month for non-blind individuals and $2,590 per month for blind individuals.)
    
2. Severity of Condition: The second step assesses whether the medical condition significantly limits the applicant’s ability to perform basic work activities.
    
3. Listed Impairments: The SSA then compares the applicant’s condition to its list of impairments. If the condition matches a listed impairment, the applicant is automatically considered disabled.
    
4. Past Relevant Work: Fourth, the SSA examines whether the applicant can perform any relevant work they did in the past five years. This five-year marker, down from 15 years, became effective in June 2024. Additionally, the SSA will no longer require applicants to describe work they performed for fewer than 30 calendar days.
    
5. Any Other Work: The final step evaluates whether the applicant can adjust to any other work available in the national economy. The SSA considers their age, education, and work experience when determining their ability to find new work.

Other Improvements

In addition to reducing the number of years an applicant has to report relevant employment from 15 to five, the SSA has improved the application process in other ways.

Streamlined Application Process

The SSA’s online disability benefits application simplifies the process and reduces paperwork. This online platform guides applicants through the process, ensuring they provide all necessary information and documentation upfront.

Updated Medical Listings

The SSA has updated its medical listings, which serve as the criteria for determining whether an applicant’s condition qualifies as a disability. These updates reflect advances in medical knowledge and diagnostic techniques, making it easier for applicants with certain conditions to qualify for benefits. Conditions such as cancer, neurological disorders, and immune system disorders now have more precise and inclusive criteria. This reduces the need for extensive medical evidence and additional evaluations.

Fast-Tracked Disability Determinations

To fast-track disability determinations for individuals with severe medical conditions that clearly meet SSA’s disability standards, the SSA has expanded its Compassionate Allowances program. Compassionate Allowances are given as soon as cases are confirmed for certain medical conditions, such as Lou Gehrig’s disease (ALS) and pancreatic cancer.

Revised Work Evaluation Rules

To address the difficulties faced by older applicants and those with limited work experience or education, the SSA has revised its vocational guidelines, making it easier for them to qualify for benefits. These revisions acknowledge the difficulties faced by individuals in these categories when trying to find new employment.

Learn More About Disability Benefits

The rules for SSI and SSDI requirements can still prove complicated, so you may likely have questions about the disability benefits application process or your unique situation. Enlisting the help of a special needs planning attorney near you can make your application process easier. They can discuss your specific situation and your options with you.

For additional reading on the SSA and disability benefits, check out the following articles:

• Can I Collect Social Security and Still Work?
• Updates to Social Security Administration Portal Make It Easier to Complete Key Tasks Online
• Mental Illness and Social Security Disability Benefits