Social security disability insurance (SSDI) is a government program designed to support individuals whose medical conditions make it impossible to maintain gainful employment. While SSDI can provide a safety net for the disabled, it can be notoriously difficult to obtain.
If you’re suffering an injury or illness that prevents you from working, and you’re struggling to obtain SSDI benefits, you may be wondering who is eligible for SSDI. If you’ve been denied benefits, you may be overwhelmed and confused about what to do next.
At Bailey & Galyen, we understand how challenging it can be to obtain adequate SSDI benefits and how frightening it can feel to be turned down for SSDI altogether. Texas social security disability lawyers fight relentlessly for you, clearing any obstacles that prevent you from obtaining the maximum compensation you deserve.
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What Is SSDI?
Social security disability insurance is a federal program that provides financial assistance to individuals who have paid into social security through their jobs but are now unable to work because of a medical condition. Unlike supplemental security income (SSI), SSDI eligibility is based on your disabled status and your work history, not financial need.
You must meet specific criteria to qualify for SSDI. The criteria include medical and non-medical requirements. You must have a documented disability that prevents you from performing substantial gainful activity (SGA), and you must have earned enough work credits through previous employment. Below, we break down these criteria to help you better understand your eligibility.
Medical Conditions That Qualify for SSDI
The cornerstone of SSDI eligibility is proving that you have a disabling medical condition recognized by the Social Security Administration (SSA). The SSA maintains a list of impairments, often referred to as the “Blue Book,” that outlines conditions automatically considered severe enough to warrant benefits. Common qualifying conditions include:
- Neurological disorders such as multiple sclerosis, epilepsy, or ALS
- Mental health conditions like severe depression, bipolar disorder, or schizophrenia
- Chronic illnesses, including cancer, chronic heart failure, or kidney disease
- Musculoskeletal disorders such as herniated discs or severe arthritis
Even if your condition isn’t listed, you may still qualify if you can demonstrate that it prevents you from being able to work. Medical evidence, such as diagnostic tests, treatment records, and physician statements, will play a vital role in proving your claim.
What Counts as a Disabling Condition?
Having a medical condition is not enough to qualify for SSDI. Your condition must meet the SSA’s strict definition of disability. This means:
- It must prevent substantial gainful activity (SGA): Your condition must limit your ability to earn more than a specific monthly income set by the SSA.
- It must last at least 12 months or result in death: Temporary or short-term conditions are not eligible.
- It must be well-documented: Comprehensive medical evidence, such as doctor’s notes, test results, and treatment records, is essential to prove your claim.
The SSA makes disability benefits notoriously difficult to obtain. Our experienced attorneys can gather and present documentation that will strengthen your application and improve your chances of being approved.
Work History and Credits: The Non-Medical Requirements
SSDI eligibility also depends on your work history. To qualify, you must have paid into social security through payroll taxes for a specific period. This is measured by work credits, which you earn based on your annual income.
- Most adults need 40 work credits, with at least 20 earned in the 10 years prior to becoming disabled.
- Younger workers may qualify with fewer credits, depending on their age at the time of disability.
If you’re unsure about your work credits, the SSA can provide a statement showing your earnings record and the number of credits you’ve accumulated.
Common Myths About SSDI Eligibility
There are several misconceptions about who is eligible for SSDI. Let’s address a few:
- “I can’t apply because I’m still working part-time.” Part-time work doesn’t automatically disqualify you, as long as you earn less than the SGA limit.
- “My condition isn’t on the SSA’s list.” You can still qualify if your condition prevents you from working and meets the SSA’s severity criteria.
- “I’m too young to qualify.” Younger workers may be eligible with fewer work credits.
Never assume that you’re ineligible for SSDI benefits because of common misconceptions. A qualified SSDI lawyer can evaluate your case and help assess your eligibility.
What If Your Application Is Denied?
Many first-time SSDI applications are denied, usually because of incomplete paperwork or insufficient evidence. If this happens, you have the right to appeal the decision. The appeals process includes multiple steps:
- Reconsideration: A fresh review of your claim by someone not involved in the original decision
- Hearing before an administrative law judge (ALJ): An opportunity to present new evidence and clarify your case
- Appeals Council review: A final SSA review, if your ALJ hearing doesn’t resolve the issue
You have a lot at stake to risk being turned down for SSDI on appeal. Working with an experienced SSDI lawyer is the most effective way to gain approval for a previously denied claim.
When Should You Seek Legal Help?
Ideally, you should hire a knowledgeable SSDI attorney before you submit your first claim for benefits. Working with an attorney early in the process can significantly boost your chances of approval. It ensures your application is properly prepared and includes all the necessary documentation.
However, if you submitted an SSDI application on your own and it was denied, working with an experienced attorney is every bit as important. After being denied the first time, you want to do everything you can to increase your chances of approval on appeal.
Applying for SSDI starts with gathering all the necessary information to support your claim, including:
- Personal information: Your social security number, birth certificate, and work history
- Medical documentation: Detailed records of your diagnosis, treatments, and limitations
- Financial details: Information about any other benefits or income you receive
While the process may seem straightforward, small errors or missing details can delay or derail your claim—another reason why having legal guidance can be invaluable.
Why Choose Bailey & Galyen?
Navigating the SSDI process can feel like a full-time job—especially when you’re already managing the challenges of a disabling condition. At Bailey & Galyen, we approach every case with empathy and outstanding customer care, helping clients understand their options and advocate for their rights. We focus on:
- Learning about your unique situation: Every client’s story is different, and we take the time to understand yours.
- Building strong applications and appeals: From medical records to personal testimonies, we make sure every detail supports your case.
- Providing ongoing support: Whether you’re applying for the first time or fighting an appeal, you can rely on our team to stand by your side.
Contact Us Today
Determining who is eligible for SSDI shouldn’t be a mystery. If you’re living with a disabling condition and need financial support, let Texas personal injury lawyers help. From initial applications to complex appeals, we’re here to advocate for you every step of the way.
Contact us today at (817) 345-0580 or reach out to us online to schedule a free consultation and take the first step toward securing the benefits you deserve.