Medical Eligibility Rules in a Social Security Disability Application

For you to become eligible to receive disability benefits from either the Social Security Disability Insurance (SSDI) or the Supplemental Security Income (SSI), you must be able to provide proof that you are disabled as defined by the Social Security Administration (SSA). You must also have enough work credits to be considered "insured" for the SSDI program, or that you have low income and resources to be eligible for the SSI program.

It is worth noting that the SSDI is a program in which regular employees and self-employed individuals are paid monetary benefits and other non-monetary assistance based on their tax contributions to the Social Security funds and on their work history. On the other hand, the SSI is a program that does not base on the workers' work history, but rests solely on the basis of their low income and resources.

Medical Eligibility

The SSA determines your eligibility to receive either the SSDI or SSI benefits. Their basis rests on your evidentiary documents, particularly those related to your medical condition. Since the SSA has its own definition of disability, it is obvious that you have to provide medical proof to show that your current disability prevents from working.

When you apply for Social Security Disability claim that contains filled-up application forms and evidentiary requirements, the SSA will not be the only ones who will go over it. The Disability Determination Services (DDS) will also take a look at your claim, especially your medical proof. The DDS is a state-run agency that is tasked to determine if your disability is severe enough to give you benefits.

Moreover, the DDS will take a look at the List of Impairments, colloquially known as the "Blue Book". It is a manual that contains a list of medical conditions that are considered severe that will entitle you to receive disability benefits. If they see that your condition matches one of those listed in the said manual, then you are automatically eligible for benefits. If not, the DDS will try to match the severity of your condition to the one listed on the "Blue Book".

Also, the DDS will look at the possibility of you returning to your past work based on limitations that you have. If they saw that you can only exert light work given that your previous job requires you to exert work in the medium level, then you are not expected to get back to work.

However, the DDS may also look at the possibility of you doing "other work". If they do find out that you are capable of doing other work, then you cannot anymore be eligible to receive benefits.