Social Security Disability Insurance (SSDI) is designed to provide financial help for people with disabilities who are unable to work. However, SSDI eligibility hinges on the Social Security Administration’s definition of disability, which is more complex than many people realize. At Nappa, Monterosso & Poznansky, LLP, our Social Security disability lawyers on Staten Island help clients in the greater NYC area understand this definition as we assist with Social Security Disability applications and appeals.
The SSA’s Disability Definition and Criteria
The SSA’s definition of disability is multifaceted. To meet their definition of disability, you must be unable to engage in any substantial gainful activity (SGA) because of a medically determinable physical or mental impairment that has lasted or is expected to last for 12 months or is expected to result in death. Work is considered substantial if it involves doing significant physical or mental activities for pay or profit. If you are blind, SGA is not a factor when determining initial eligibility for SSDI benefits.
Another important element for SSDI eligibility is that the impairment be severe. This means that the impairment significantly limits your physical or mental ability to perform basic work activities, which may include:
- Remembering, understanding, or carrying out instructions
A person’s impairment must meet or be medically equivalent to the criteria of a condition listed in SSA’s Blue Book. Our attorneys have a deep understanding of these conditions and are well-versed in the nuances of how they may apply in each individual case.
The amount of benefits you may receive depends on how much you have paid into Social Security from previous earnings withholdings.
What Is the SSA’s Blue Book?
The SSA's Listing of Impairments, also known as the "Blue Book," describes conditions considered severe enough to prevent someone from engaging in any gainful activity. It is a comprehensive guide that outlines various medical conditions and the criteria for each condition to be considered disabling.
If a person’s impairment meets or is medically equivalent to the criteria outlined in the Blue Book, they may be eligible for Social Security Disability benefits. It's important to note that the disability determination process involves a thorough evaluation of medical evidence, work history, and other factors. Each case is unique, and determinations are made on an individual basis. Choosing the right disability attorney who’s familiar with the Blue Book is vital to pursuing a successful claim.
Social Security Disability Requirements and Criteria
The disability determination process is meticulous and involves a thorough evaluation of medical evidence. Medical records, physician statements, and other relevant documentation play a crucial role in establishing the severity of an impairment. The SSA also may consider the individual's work history, education, and skills to assess their ability to engage in other types of gainful employment.
According to the SSA, someone is considered disabled if they meet the following criteria:
- Unable to work – The applicant must be unable to engage in substantial gainful activity (SGA) due to a severe medical impairment. The impairment must prevent them from performing their previous work and any other type of substantial gainful work.
- Severe Impairment – The person must have a medically determinable impairment that is severe. A severe impairment significantly limits the individual's physical or mental ability to do basic work activities.
- Duration of disability – The impairment must be expected to result in death or be expected to last for a continuous period of at least 12 months.
- Listed impairments or equal severity – An impairment must meet or be medically equivalent to the criteria of a condition listed in the SSA's Listing of Impairments, or Blue Book.
The SSA recognizes that the impact of a medical impairment may vary widely among individuals. Each determination is made on a case-by-case basis. The SSA considers the nature of the disability and the unique circumstances and challenges faced by each applicant. It's important to note that the SSA's definition of disability is not limited to physical impairments. Mental health conditions and their impact on a person’s ability to work also are considered.
Applying for Social Security Disability Benefits
The disability application process involves the submission of detailed information about the individual's medical condition, work history, and daily activities. The SSA may request additional medical examinations or consultative evaluations to gather comprehensive information for the decision-making process. If you’re wondering what medical conditions qualify for Social Security Disability benefits, a few common examples include:
- Musculoskeletal problems, such as back injuries or amputation
- Cardiovascular conditions, such as coronary artery disease or heart failure
- Vision and hearing loss
- Respiratory illnesses, including mesothelioma, asthma, and COPD
- Neurological disorders such as multiple sclerosis, Parkinson’s disease, or epilepsy
- Mental health conditions, such as bipolar disorder or depression
- Intellectual disorders, such as autism or mental disability
- Immune system disorders, including rheumatoid arthritis or lupus
- Skin disorders, such as atopic dermatitis (eczema) or burns
- Digestive tract issues, such as inflammatory bowel disease (IBD)
- Kidney disease and genitourinary problems
This is by no means an exhaustive list of the conditions included in the SSA Blue Book. Our Social Security Disability lawyers thoroughly evaluate your case and medical history to determine whether a successful SSDI claim may be a possibility. If you have already applied and need assistance with a Social Security Disability appeal, our experienced legal team can assist you with the process.
Contact a Social Security Disability Lawyer in the Greater NYC Area
If you or a loved one is injured and unable to work, our team at Nappa, Monterosso & Poznansky, LLP, can help you understand whether your situation meets the Social Security definition of disability and help you obtain the benefits you need. To schedule a free case evaluation for your workers’ compensation or Social Security Disability claim, call us at 718-273-9000 or contact us online.
For more information about the Social Security Administration’s definition of disability, check out their website.