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“Do I Qualify for Disability?”

Riddle Brantley LLP   |  May 8, 2020   |  

Do I Qualify for Disability - SSA Eligibility Criteria

“Do I qualify for disability?” This is one of the most frequent questions our North Carolina disability lawyers get from clients. In this blog post, we’ll outline some important things to keep in mind if you’re wondering, “Can I get Social Security disability?”

In order to qualify for disability, a person must suffer an injury so serious, or get so sick, or have mental health conditions so bad, that they simply cannot go to work. If their symptoms show no signs of letting up after a few months, they may wonder, “Do I qualify for disability?”

Here are a few general guidelines for helping determine whether or not you qualify for Social Security disability benefits.

First, how bad off do you have to be in order to be considered “disabled?”

The Social Security Administration (“SSA”) has a very specific definition of “disability.” To meet it, you must be so impaired that you cannot engage in what the SSA calls “substantial gainful activity (SGA).” In simplest terms, SGA means working and earning above a certain modest amount. The specific amount is adjusted for inflation every year. In 2020, the amount is $1,260 per month. This is called the “SGA threshold.” If you are earning more than that (gross) every month, you are, by definition, NOT disabled, no matter how bad your medical condition might look on paper. The SSA uses other ways of testing self-employed or contract workers to see whether they are working over the SGA threshold.

So, that’s the first step in determining if you qualify for disability.

SGA Threshold for Social Security Disability - Do I QualifyHowever, this does not mean that you cannot work at all to be found disabled by the SSA. Many people with serious medical problems are still able to work part-time when they apply. It is often very difficult and painful, but some folks have no choice but to power through their ailments until they get approved for benefits in order to avoid homelessness or starvation.

As long as you do not earn over the SGA threshold, you are still eligible. Keep in mind, however, if you’re wondering, “Do I qualify for disability?”, the general rule is that the more part-time hours you CAN work, even if it’s difficult, the more the SSA will think you COULD work full-time. This may make it more difficult to qualify for disability.

So, if you’re wondering “Do I qualify for disability?” or “Can I get disability benefits?” you should first consider whether you’re earning more than the SGA threshold.

But let’s assume you are not working over the SGA threshold. Now what?

The next thing you have to show is that the reason you are not working is because of a very serious, and objectively diagnosed, health problem, or what the SSA calls “a medically-determinable physical or mental impairment that is expected to result in death, or that has lasted or is expected to last for a continuous period of at least 12 months.”

In other words, in order to qualify for disability, you have to have proof of a very severe medical problem that is not likely to get better any time soon.

Things like wrist or ankle sprains or broken bones rarely qualify because they rarely take a year to recover from. On the other hand, bad backs, especially those that have been treated medically for years, often do qualify, especially when one or more surgeries have failed.

“How does ‘residual functional capacity’ affect if I qualify for disability?”

What is Residual Functioning Capacity Once you show that you’re not working (or working very little) and that you have a serious medical or mental health problem, the SSA then determines what you can or cannot be expected to do, given those problems. They call this determining your “residual functional capacity” or RFC.

In order to determine your RFC and see if you qualify for disability, the SSA will review your medical records and any other supportive letters or forms from your doctor, from you, and from your family and friends.

Your RFC is an evaluation of the level of work you can still do. It places you on a scale from Sedentary (lifting very little weight and mostly sitting down) to Light (lifting more, standing and walking more), to Medium (still more physically demanding), to Heavy or even Very Heavy. The more limited your RFC, the greater the likelihood that the answer to “Do I qualify for disability?” will be “Yes.”

“I have a mental illness or disorder. Do I qualify for disability?”

If your main problems are psychological or psychiatric, or otherwise having to do with your brain functioning, SSA will make a separate measure of your mental “residual functioning capacity” (see below). This is intended to determine how well you can still do the mental things it takes to hold down a job, like understanding and remembering instructions, maintaining attention and concentration, interacting appropriately with others, and responding appropriately to changes or hazards in the workplace.

SSA will make their determination whether you are capable of any work at all, and if so, whether it can be unskilled, semi-skilled, or skilled work.

For more on disability for mental health, please view our related blog post.

“How does my previous work impact my application for disability?”

Once your physical and mental RFC’s are set, the SSA will look at whether you can still do the types of work you’ve done over the past fifteen years. If they decide you can, then you will be found not disabled. If they decide you cannot, however, it gets a little more complicated. SSA then has to determine whether you can work at other, simpler, easier jobs than what you’ve done in the past.

This is the point at which your age is a very significant factor.

Do I Qualify for Disability - How Does Age Affect EligibilityPeople under 50 are considered “younger” by the SSA, and younger people are presumed to be better able to adapt to different types of work than those over 50. This is an arbitrary, and sometimes unfair, dividing point, but unfortunately the system is what it is, and we are stuck with it.

The practical effect of this rule is that people over 50 seeking disability benefits are statistically more likely to be approved than those under 50, all other things being equal.

So… “Do I qualify for disability?”

So, let’s assume you’ve made it this far in the process. If you think you may qualify for disability, now you may be wondering what benefits you are eligible to collect.

There are two potential programs in play: Social Security Disability Income (“SSDI”) and Supplemental Security Income (“SSI”).

What’s the difference between SSDI and SSI?

You are only eligible for SSDI if you have earned reported wages and paid into the system for a certain amount of time. The specific amount of time varies depending on your age — generally it means at least half of the time since you became an adult or five years, whichever is less. The amount of SSDI benefits then depends on how long, and how much, you paid into the system.

In 2020, the maximum amount of benefit you can receive under SSDI is $3,011/month, no matter how much money you earned and paid into the system. Most benefit levels are lower than that; the average in 2020 is around $1,250.

On the other hand, you can be eligible for SSI whether or not you have worked and paid into the system, as long as your income is very low (far less than $1,000/month, gross) and you own very little or no property. In other words, SSI is a program designed to help poor people who are too sick or injured to work, whether or not they’ve worked before.

The maximum benefit for SSI recipients is only around $780/month, so all it really does is keep a person from starving to death. SSI recipients are generally also eligible for Medicaid coverage for their health problems as well as other government programs for the needy, especially those with children.

It is possible to be eligible for both SSDI and SSI if you worked and paid into the system AND are currently without significant income or assets.

So, let’s summarize…

If you’re asking, “Do I qualify for disability?” here’s what you need to know about qualification criteria used by the Social Security Administration:

  • You must not be working, or working very little, to be eligible to apply for disability benefits
  • You must be able to prove that you have a diagnosed medical or mental health condition that is terminal or practically permanent in duration
  • You have to establish that your residual functional capacity (RFC) is so limited that you cannot be expected to perform even the simplest, easiest of jobs, even more so if you are under 50
  • The type and level of benefit you can receive depends on your income and property-ownership situation and whether you’ve paid into the system in the past

Keep in mind, determining whether or not you qualify for disability can be far more complicated than this. This is just an extremely simplified overview intended to help you answer your question, “Do I qualify for disability?”

It is important to remember that each person’s situation is different and unique. The only way to know if you qualify is to discuss it with a knowledgeable and experienced disability attorney who knows the law.

Do You Qualify for Disability? Riddle & Brantley Can Help

If you’re wondering, “Can I get disability benefits?” or “Do I qualify for disability?”, the experienced North Carolina disability attorneys at Riddle & Brantley can help.

Our team is led by a Board-Certified Specialist in Social Security Disability, Scott Scurfield, who knows the Social Security Disability system inside and out and can help evaluate your claim and determine the best legal path for seeking benefits.

“Nothing makes me happier than to get my clients the disability benefits they need and deserve.”

-Scott Scurfield, lead disability attorney at Riddle & Brantley

For a FREE consultation with a North Carolina disability lawyer at Riddle & Brantley, please call 1-800-525-7111 or complete the short form below.

There are no upfront costs and no attorney fees unless we successfully obtain Social Security disability benefits for you.

NC Disability Lawyer at Riddle & Brantley - Free ConsultationPlease call 1-800-525-7111 to speak with an experienced disability attorney today.

“It has been said that ‘justice delayed is justice denied’ and nowhere is that more true than in the Social Security Disability system,” says Scott Scurfield, lead disability attorney at Riddle & Brantley.

“People who cannot work are almost always in dire financial straits, and the time it takes to get through the system is way too long. We do everything in our power to keep that wait time to a minimum and get our disabled clients the benefits they have earned. Nothing makes me happier than to get my clients the disability benefits they need and deserve.”

Riddle & Brantley is committed to justice for ALL North Carolinians with disabilities. We are proud to serve Raleigh, Durham, Fayetteville, Goldsboro, Greenville, Kinston and Jacksonville. We’ll even come to you if it’s more convenient.

Please note that in-person consultations are available in Durham, Fayetteville, Greenville and Kinston by appointment only. Walk-in appointments are welcome at all other locations and we can consult with you by phone, email or video conference from anywhere.

For a FREE, no-obligation consultation with a Board-Certified Specialist in Social Security Disability, please call 1-800-525-7111.

“If you have a disability and are looking for someone to fight for you, I can promise Scott Scurfield will … They made a hard time in my life easier to endure.”

-Melissa C., Riddle & Brantley client

You don’t have to go through this alone. If you suffer from a disability and are unable to work, we would love to help you get the benefits you deserve however we can.

Please call 1-800-525-7111 today and let’s review your case.

Justice Counts for ALL North Carolinians with disabilities.