When is an injury or illness severe enough for SSDI benefits?

On Behalf of | Sep 20, 2023 | Social Security Disability Insurance |

Working professionals in the United States contribute a small portion of their income from each paycheck toward Social Security programs. Most adults will only need the support of Social Security benefits when they reach retirement age. However, for a small minority of workers, Social Security benefits could become necessary if they desire to continue living independently after a medical incident or acquired condition leaves them unable to work.

Social Security Disability Insurance (SSDI) benefits are a crucial social safety net for those who are not old enough to retire but who have medical conditions that prevent them from seeking full-time, gainful employment. Workers often struggle to evaluate their own circumstances honestly and may have a hard time determining whether or not they qualify for SSDI benefits. The following are the main requirements for a worker who hopes to receive SSDI benefits.

The condition must be debilitating

The Social Security Administration (SSA) maintains a relatively comprehensive list of different types of medical conditions that could leave someone unable to work. From neurological and mental health conditions to debilitating cancers, any of these medical concerns could potentially make someone eligible for SSDI benefits. However, each case is unique, and it will be the severity of someone’s condition, rather than a specific diagnosis, that will determine whether someone receives SSDI benefits or not. Someone will usually need sufficient medical documentation to establish that the condition they have prevents them from pursuing any form of gainful employment if they hope to qualify.

The condition will need to last at least a year

There are certain conditions that leave someone completely unable to work but will not qualify them for SSDI benefits. A broken bone would be a perfect example. Someone might require several months away from their job after a fracture, but even if they require surgery, they will likely be able to return to work after a few months. For SSDI benefits to be an option, someone’s condition will need to last for at least a year. Those with terminal conditions or incurable medical challenges that will last for the rest of their life will likely have the strongest claim to SSDI benefits.

Those who don’t get approved initially when they apply for benefits may have failed to submit adequate documentation showing either the severity of their condition or how long it will last. Learning about the criteria for SSDI may help people with the initial application process or may give them confidence about the decision to appeal the initial determination in their case.

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