Most people in Illinois know that qualifying for Social Security Disability benefits can be challenging, even in cases of severe disability. Many people wonder whether any conditions are serious enough to automatically merit benefits. Though there are certain conditions the SSA recognizes as disabling, the decision to award disability benefits is never guaranteed.
SSD applicants always risk claim denial if they do not provide adequate medical documentation. Furthermore, SSD applicants must meet certain criteria regardless of the severity of their conditions.
The SSA publishes a “Blue Book” of impairment listings, or recognized disabling conditions. If an individual suffers from one of these conditions and the condition meets the SSA’s requirements for severity, the individual qualifies for benefits. Rather than evaluating the individual’s ability to work, the SSA assumes the condition is disabling.
The SSA also recognizes certain conditions that are serious enough to deserve expedited processing through the Compassionate Allowances Program. This list includes more than 150 conditions that virtually always qualify for benefits. The SSA establishes severity criteria for some of these conditions, while others are considered disabling in any form.
People with an impairment listing or a Compassionate Allowances condition must provide extensive evidence of the condition and its effects. If medical documentation does not prove the individual meets SSA listing or severity criteria, claim denial is likely. Similarly, if the documentation is more than 90 days old, the claim will be denied. The SSA only accepts current medical records.
Even if these medical criteria are met, an applicant still must meet the SSA’s employment and earnings record criteria to qualify for benefits.
People with recognized disabling medical conditions may only receive benefits if they meet the following standards:
- Recipients cannot be engaged in “substantial gainful activity.” In 2014, this is employment paying more than $1,070 per month, with an exception for blind individuals, who can earn up to $1,800 each month.
- Recipients should be eligible for SSD benefits based on their earnings records. Recipients must have at least 40 work credits. In 2013, $1,160 of income was worth one credit.
- Recipients need a recent work history. Recipients must have worked 5 years during the last decade or earned 20 credits during the decade before the disability developed.
The SSA always verifies these requirements are met before reviewing the applicant’s medical information. If the applicant meets medical standards, the SSA again confirms that the individual is not engaging in SGA. If the individual’s earnings are still below the SGA threshold, then benefits are awarded.