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When does a medical condition qualify someone for SSDI benefits?

On Behalf of | Aug 27, 2023 | Social Security Disability |

Every working adult in the United States, including employees and independent contractors, make regular contributions to the Social Security program. Many people only benefit from those contributions when they are over retirement age and no longer working.

However, a small minority of workers end up experiencing some kind of medical emergency or suffering an injury that leaves them unable to continue working while still too young to retire. The Social Security Administration (SSA) does not just oversee retirement benefits. There are also disability benefits available to people in different situations.

The Social Security Disability Insurance (SSDI) program can help previously gainfully employed adults cover their cost-of-living expenses when a debilitating medical condition forces them to stop working far earlier in life than they ever anticipated, for example. Qualifying medical conditions typically need to meet two very important standards established by the SSA.

The condition must be debilitating

For someone’s health issues to qualify for SSDI coverage, they usually need evidence supporting their claim that their condition completely prevents them from pursuing gainful employment. Someone who could continue to work as a cashier or an administrative assistant might not qualify for benefits even if they have to leave their current job. A medical condition generally needs to completely prevent someone from working in order to qualify. The more documentation someone has affirming the severity of their condition and the symptoms they experience, the better their chances of getting approved for SSDI benefits.

The condition must last for a significant period

Even if a broken bone could force someone to take a lengthy leave of absence from their job or prevent them from working anywhere, it would not qualify for SSDI benefits. Generally, a condition either needs to last for at least a year or persist for the rest of someone’s life for them to qualify for SSDI benefits. Fractures and other conditions that will resolve in a few months will not result in SSDI benefits even if those health concerns keep someone away from work for multiple months.

Provided that there are records affirming both the severity and the likely duration of someone’s medical condition, they can potentially apply for SSDI benefits and appeal if the original decision on the matter is not in their favor. Learning more about the standards for SSDI benefits claims and seeking legal guidance accordingly can help those worried about supporting themselves after an injury or illness.