Do I Qualify For Social Security Benefits?

Do I Qualify For Social Security Benefits?

We get calls almost every day from people wanting to know “Do I qualify for Social Security benefits?” The short answer is that if you are not able to work and the reason you are not able to work is because of a medical condition or a combination of medical conditions, you will most likely meet the threshold requirements to at least be able to apply.  Of course, being eligible for benefits and actually being awarded benefits are not the same thing.  

There are two kinds of disability programs: social security disability insurance, called SSDI for short, and supplemental security insurance, or SSI for short.  A person’s eligibility for SSDI depends on how much he or she has worked in the past and how many quarters of earnings they have paid in Social Security taxes.  Sometimes you will hear this referred to as “credits.”  Eligibility for SSDI may also depend on how recently the person earned the credit.  As a general rule, if you’ve had earnings sufficient for a quarter of coverage in five out of the past ten years, you will be eligible for SSDI.  Another way to say it is that you need at least 20 credits out of the last 40 to be eligible. 

SSI on the other hand is a needs-based program and Social Security will look at a person’s financial resources to determine if he or she is eligible.  Sometimes people are eligible for both SSDI and SSI.  While it is unusual, sometimes a person is not eligible for either.  

I was denied, should I just give up?

Getting a denial from Social Security can be very discouraging.  However, Social Security routinely denies claims, even good ones and you should not give up just because you received a denial. In fact, the majority of claims are denied at least once, and most are denied twice. Sometimes getting approved is about not getting discouraged and just moving forward in the process.  When you receive a denial, you will have 65 days from the date of the denial to appeal.  Although this seems like a lot of time, 65 days can go by fast.  You would be smart to speak with an attorney and get your appeal filed as soon as possible.

Social Security will surely see that I am disabled.  So, why do I need an attorney?

While you may have very serious medical problems, Social Security’s definition of disability is a legal one.  With a few exceptions, it takes more than just a serious health condition to establish disability.  There are both vocational and legal considerations.  An attorney can not only help you navigate the disability process, he can also help you develop the right evidence in your case to show that you meet the legal definition of disability.  Keep in mind that Social Security places the burden of “proving” disability onto the claimant.  I often tell clients that a diagnosis alone is not enough to prove disability.

Having a lawyer represent you offers you the best chance of success.  Plus, it does not cost anything to you upfront to hire a lawyer, and you only pay an attorney fee if your claim is approved.  If your claim is approved, the most that most people will pay in attorney fees is $7,200.00.  Frankly, this is an excellent value considering the monetary and medical benefits you will receive in exchange.

Can I work while I am applying for disability benefits?   

The quick answer is that you can work while your application for disability benefits is pending as long as your work does not rise to the level of what Social Security calls “substantial gainful activity” or “SGA”.  For most people, SGA refers to the maximum amount of gross income a person can earn from work activity per month.  In 2024, for non-blind individuals, the SGA amount is $1,550.00 a month.  This means that if you earn $1,550.00 or more in gross income per month, Social Security presumes you are not disabled.  It will not even look at the severity of your medical impairments.

The more complicated answer is that even work that falls below SGA during the pendency of your application can compromise your case and result in a denial.  This is because working even a few hours a week may be inconsistent with work preclusive limitations that you may have to prove you have in order to be found disabled.  In other words, any work activity can bring into question your true work capabilities.

I will never tell a client not to work.  In fact, my advice is to work as long as possible.  But work activity of any kind can have a major consequence on your claim.  This is even more true for self-employment.  Social Security uses a different test to determine if self-employment rises to the level of SGA.  This test is very complicated but suffice it to say that self-employment is never a good idea during the pendency of a disability application.  If you must work, it is best to work below SGA as a W-2 employee.

Jerry Pryor

Jerry was admitted to the Massachusetts Bar in 2008 and the Florida Bar in September 2013. He has experience practicing in a number of different areas of the law but now focuses his practice on representing clients before the Social Security Administration and in the area of Workers’ Compensation.