Thursday, January 16, 2020

What is a Qualifying Condition for Social Security?


While Social Security payments are generally thought of as repayments for taxes paid into the system while working, there are two types of Social Security benefits that are primarily based on the recipient’s physical or mental disabilities. Retirees can collect Social Security payments beginning at age 62, but most wait until their full retirement age which ranges from 65 to 67, depending on their birth year. Payments based on disabilities have a wide range of requirements, including whether the recipient has a specific qualifying condition.

Supplementary Security Income (SSI) is designed for people with limited income and resources who are disabled, blind, or age 65 or older. Blind or disabled children may also get SSI. Social Security Disability Insurance (SSDI) pays benefits to the recipients and certain family members if the recipient worked long enough and paid Social Security taxes.

Definition of Disability

For potential SSDI recipients, the Social Security Administration (SSA) considers you to be disabled if:
  • You cannot do work that you did before;
  • You cannot adjust to other work because of your medical condition(s); and
  • Your disability has lasted or is expected to last for at least one year or to result in death.

SSA will ask you five questions to determine whether you are considered disabled for the purposes of receiving benefits:
  • Are you working?
  • Is your condition “severe”?
  • Is your condition found in the list of disabling conditions?
  • Can you do the work you did previously?
  • Can you do any other type of work?

A child under age 18 will be considered disabled if he or she has a medically determinable physical or mental impairment or combination of impairments that causes marked and severe functional limitations, and that can be expected to cause death or that has lasted or can be expected to last for a continuous period of not less than 12 months.

Qualifying Conditions

Depending on the answers to SSA’s questions and on other factors, including age and income, there are many qualifying conditions that would enable a person to receive disability benefits. Medical criteria for disability determination is divided into fourteen separate areas, with multiple qualifying conditions listed within each section:
  • Musculoskeletal System
  • Special Senses and Speech
  • Respiratory Disorders
  • Cardiovascular System
  • Digestive System
  • Genitourinary Disorders
  • Hematological Disorders
  • Skin Disorders
  • Endocrine Disorders
  • Congenital Disorders that Affect Multiple Body Systems
  • Neurological Disorders
  • Mental Disorders
  • Cancer (Malignant Neoplastic Diseases)
  • Immune System Disorders     

Examples of these conditions include:
  • The inability to move effectively or the inability to perform fine and gross movements effectively lasting, or expected to last, for at least 12 months.
  • Disorders of the veins or arteries (for example, obstruction, rupture, or aneurysm) that cause impairments of the lower extremities (peripheral vascular disease), the central nervous system, the eyes, the kidneys, and other organs.
  • Disorders that result in chronic kidney disease.
  • Neurological disorders that may manifest in a combination of limitations in physical and mental functioning, such as Huntington’s Disease.
  • Impairment of the mental functioning a person uses in a work setting: understanding, remembering, or applying information; interacting with others; concentrating, persisting, or maintaining pace; and adapting or managing oneself. 
  • Impairment that results from pituitary gland, thyroid gland, parathyroid gland, and adrenal gland disorders.

Conditions Qualifying for Fast-Tracked Claims

SSA’s Quick Disability Determination (QDD) electronic system screens applications for disability benefits for keywords. Applicants reporting certain conditions may qualify for accelerated processing. For example, an applicant that:
  • Has a condition which has reached a terminal stage
  • Is in imminent danger of becoming homeless
  • Does not have a specific disease but may have extenuating circumstances, such as a low birth weight infant
  • Has one of approximately fifteen severe physical or intellectual impairments, such as amputation, Down Syndrome, total blindness or deafness, or HIV/AIDS
  • Is a veteran who became disabled while on active duty, whether or not the disability occurred in the course of military action, if it occurred since October 1, 2001.

Find Out More About Qualifying – Contact the Driscoll Salazar Disability Group Today

The wide range of disability requirements can be confusing. To learn more about whether you might have a qualifying condition, don’t hesitate to contact the Driscoll Salazar Disability Group by calling 949-359-1370.

We’ve helped many clients and we know what SSA is looking for when reviewing applications. We will work with you to be sure that you are providing SSA with all the information they’ll need to determine your eligibility.


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