Who qualifies for disability in either the SSD or SSI program - eligibility

Who qualifies for disability benefits from the social security administration? Though there are two separate disability benefit programs administered by SSA, the answer, as to who qualifies for disability, is the same.

An applicant who qualifies for disability will have had their medical records read and evaluated by a disability examiner at an agency that renders decisions on social security disability and SSI claims. This agency is known in most states by the name Disability Determination Services (in some states, it is called the division or bureau of disability determination) and, typically, a person's case will be there for several months before a decision is made.

How is the decision made for a disability case? In brief, the disability examiner who has been assigned to the case will gather the claimant's medical records by sending out request letters to each doctor and hospital where the claimant has received medical treatment. It can take weeks or months to actually receive all the records, but once they are available a disability examiner will read and evaluate them.

After reading the medical records, the disability examiner will, in consultation with a doctor who works in the examiner's unit, determine what the claimant's functional limitations are (for example, difficulty lifting more than a certain weight, or difficulty sitting or standing for a certain length of time, or difficulty with memory or concentration).

After the limitations are determined, the disability examiner will decide whether or not the claimant can return to their past work. If the claimant can return to their past work, they will not be approved. If it is determined that the claimant cannot do their past work, then the next step will be to decide whether or not the claimant can perform some other type of work. If the answer to this question is yes, the claimant will not be approved.

However, if the answer to this question is also no, the individual's social security disability or SSI claim will be approved.

As you can see, the question of who qualifies for disability boils down to A. what the medical records have to say and B. the individual's work history. For children, of course, work history does not apply, but, rather, the history of school performance is evaluated.

Note: Disability judges at hearings use the exact same decisional process to determine who qualifies for disability.



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