Understanding eligibility for SSDI benefits

Understanding eligibility for SSDI benefits

On Behalf of | Apr 11, 2023 | Social Security Disability |

One of the most useful government financial assistance programs is the Social Security Disability Insurance (SSDI) administered by the Social Security Administration. Under this program, persons who have suffered a disabling injury or illness may obtain significant financial assistance to help pay their regular living expenses.

The first requirement for SSDI benefits is having been disabled by an illness or injury. Unlike workers’ compensation in California, the illness or injury does not need to be work-related. The only requirement placed on the disabling condition is that it must be diagnosed as permanent or likely to cause death within 12 months.

By contrast, a workers’ compensation claim must be based upon an injury or illness that was caused by a work-related condition.

Substantial gainful activity

The definition of disability for SSDI benefits depends upon the applicant’s ability to work – or, as stated in the SSDI regulations – the applicant’s ability to engage in substantial gainful activity.

“Substantial gainful activity” (SGA) is further defined as the ability to earn a specified amount in a particular calendar year. For 2023, the SGA for statutorily blind people is $2,460. For non-blind individuals, the SGA is $1,470. Thus, if an applicant is unable to earn the specified SGA, that person will be deemed to be disabled.

Evidence

The evidence of disability and causation is generally documentary. Work records can help prove that the applicant is disabled. The written opinion of a licensed health care provider can prove the diagnosis and extent of the illness or injury.

If the SSA denies the application and the applicant files an appeal, witnesses who support the application often testify in person at a video conference conducted by an administrative law judge.

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