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The unique definition of disability for SSDI eligibility

 

Federal disability programs administered by the Social Security Administration use a definition of disability for eligibility purposes unlike that used in other kinds of disability benefit programs.

Many people have only a vague understanding of what it means to have a qualifying disability for purposes of eligibility for Social Security Disability Insurance, referred to as SSDI. SSDI is a federal program administered by the Social Security Administration that is meant to be a public disability insurance program that workers pay into through their Social Security payroll deductions and the SSA administers.

If a claimant meets work history and financial eligibility requirements (they must have worked recently enough and enough over their work life to earn SSDI coverage and must not be earning more than a very low monthly wage), the main question is whether the claimant meets the program’s definition of disability.

The definition of disability for purposes of SSDI is a severe medical impairment or combination of impairments – physical or mental – expected to last at least 12 months or result in death – that prevents the person from engaging in substantial gainful activity, called SGA. Basically, SGA is work for pay that requires “significant physical or mental activities,” which can be part or full time.

It is important to remember that this definition of disability is exclusive to SSDI (and to SSI) – and is in most ways different from concepts of disability used in private insurance or workers’ compensation.

While SSDI is a disability insurance program, it is in certain ways different than most private disability insurance policies, which can cover either short- or long-term disability that prevents work. Those policies, available through employers or professional organizations or by private purchase, often pay benefits when a claimant can no longer perform their job because of disability, or cannot do any job for that reason, depending on the terms of the policy. Long-term disability under a private policy does not usually require that a disabling impairment last a minimum amount of time going into the future.

In contrast, workers’ compensation programs – that vary by state – typically involve concepts of partial and total disability or specific financial compensation for loss of a particular limb or physical function such as becoming blind in one or both eyes. Workers’ compensation benefits are normally only paid for injuries and diseases related to the workplace. Impairments and injuries for SSDI purposes must not be work-related but may be.

Anyone whose impairments are keeping them from working should speak with an attorney with SSDI experience and knowledge to understand whether it makes sense to file an application for SSDI.

The SSDI and SSI attorneys at Bartels Sherman & Wallace in Jonesboro, Arkansas, represent SSDI and SSI claimants throughout Arkansas, in Missouri, Tennessee, North Carolina and across the country.