If you are between the ages of 50 and 65 years and suffer from a disability that prevents you from working, you may be eligible for Social Security Disability benefits

What Medical Conditions Qualify for SSDI or SSI?

The Social Security Administration (SSA) has two programs available for those who can’t work because of either physical or mental conditions or injuries. These programs are called Social Security disability (SSDI) and Supplemental Security Income (SSI).

What Is SSDI?

SSDI is a benefits program that is funded through payroll taxes; it’s what you pay into every time Social Security takes a bite out of your check. As a result, SSDI recipients are insured based on the number of years they worked and, thus, the number of years they’ve contributed to the Social Security trust fund. All SSDI candidates receive “work credits” over time, which are then used to determine their eventual payouts.

What Is SSI?

In a nutshell, SSI is a need-based program, with need being determined according to your income and/or assets. Additionally, the program is funded from general taxes rather than the Social Security trust fund. As a result, you don’t pay into SSI by default. SSI qualification doesn’t rely on your work history but instead is based totally on your needs and means.

How Do You Qualify?

The SSA’s “blue book” lists the conditions and illnesses, along with the criteria for each, that make an individual eligible to receive either SSD or SSI benefits. These updated (2020) conditions are broken into 14 sections and include the below categories:

Listing 1.00 Musculoskeletal System Disorders (Spine and Joint Disorders)
Musculoskeletal system disorders are disabilities that affect your spine and/or joints that interfere very seriously with an individual’s ability to independently sustain or complete work-related activities. Some of these disorders include back injuries, Osteoarthritis, Scoliosis, Amputation, and Degenerative Disc Disease. View full Blue Book List here

Listing 2.00 Special Senses and Speech
Many times, sense and speech issues will not qualify for SSD benefits, however, there are a few exceptions that do qualify. These disabilities include the sudden onset of blindness and/or loss of hearing, the loss of speech making the individual unable to be heard or understood, and conditions that impair the loss of balance such as Meniere’s Disease. View full Blue Book List here

Listing 3.00 Respiratory System Disorder
Respiratory System Disorders refer to disabling conditions that cause breathing problems and prevent proper lung function including conditions like COPD, emphysema, tuberculosis and pneumonia. This category will also include some cancers like mesothelioma and lung cancer, as well as conditions such as sleep apnea and cystic fibrosis. To determine if you qualify for benefits under this category, the SSA will make their decision based on the results of breathing tests administered by a health professional that determine how restricted airflow is through the respiratory system. Respiratory conditions that are not consistent, such as asthma, will be evaluated based on how frequent an individual is affected by the episodes and how they interfere with their ability to work due to the need for medical attention. View full Blue Book List here

Listing 4.00 Cardiovascular System Disorders (Heart Disorders)
These disorders refer to conditions that affect the heart as well as common blood problems that include heart disease, Aneurysms and chronic heart failure. The SSA will review each claim for this category and determine the level of limitations your heart issue will create for your ability to perform the requirements of your work.  View full Blue Book List here

Listing 5.00 Digestive System Disorders
Digestive System Disorders specifically refer to disabilities that affect your digestive tract. While there are many digestive orders that are listed in this section that can qualify, there is a very specific set of requirements and a complex set of medical criteria that you must meet in order to receive benefits for this category. Some of the more common conditions that qualify for this category are Chronic Liver Disease, Crohn’s Disease, Liver Transplants, Hepatitis, Inflammatory Bowel Disease (IBS) as well as Gastrointestinal Hemorrhaging that requires blood transfusions. View full Blue Book List here

Listing 6.00 Genitourinary Disorders (Kidney, Urinary and Reproductive Tract Disorders)
Genitourinary Disorder refers to a disorder that impacts your kidney function, urinary tract or your reproductive system. Typically you will need to be required to receive dialysis for your genitourinary condition to qualify to receive benefits and the SSA will evaluate your case based on your medical history, your renal (kidney) function before dialysis, copies of your biopsies, a complete record of your therapy attempted and how the condition impairs your ability to work. Common conditions included in this category include Diabetic Nephropathy, Kidney Failure, and Kidney Cancers. View full Blue Book List here

Listing 7.00 Hematological Disorders  (Blood and Circulation Disorders)
Hematological Disorders refer to disorders that affect your blood. Some disorders include blood diseases such as anemia and hemophilia. This category also includes circulatory problems such as Raynaud’s Disease and Chronic Venous Insufficiency (CVI), as well as some conditions that affect the lymph nodes.  View full Blue Book List here

Listing 8.00 Skin Disorders
There are many different types of skin disorders that we hear about on a daily basis, but just because a skin disorder is inconvenient, that doesn’t mean that it will necessarily qualify to receive SSD benefits. To qualify for benefits, the skin disorder must be disabling and prevent you from performing the duties of your work. Some of he most common skin disorders that may qualify to receive benefits are Bullous Disease, Chronic Skin Infections, Photosensitivity Disorders and Ichthyosis. View full Blue Book List here

Listing 9.00 Endocrine Disorders (Endocrine Gland Disorders)
An endocrine disorder is a medical condition in which the endocrine glands function abnormally, resulting in a hormonal imbalance. The primary endocrine glands are the pituitary, thyroid, parathyroid, adrenal and pancreas and diseases that qualify for this category typically affect those specific glands such as Diabetes, Thyroid Disorders, Hyperglycemia and Hypoglycemia. The SSA will evaluate your disorder to determine if the condition is severe enough to preclude you from performing the basic requirements of work to decide if you will qualify for benefits. View full Blue Book List here

Listing 10.00 Congenital Disorders that Affect Multiple Body Systems (Non-Mosaic Down Syndrome)
This category refers to non-mosaic Down syndrome. Non-mosaic Down syndrome is a genetic disorder in which a person has 3 copies of chromosome 21 in all of their cells and virtually all people with non-mosaic Down syndrome have physical deformities, delayed physical development and/or intellectual disability.  View full Blue Book List here

Listing 11.00 Neurological Disorders (Nervous System Disorders)
When we hear the word Neurological we often think of the brain, however, in this category the disorder can occur anywhere in the nervous system. Disorders such as Parkinson’s Disease, Multiple Sclerosis, ALS and other nerve-based diseases are common conditions that are approved for benefits by the SSA. This category also includes Epilepsy, Cerebral Palsy and Muscular Dystrophy and it will be evaluated on how severe the disorder is and how often it requires medical attention for treatment and management. View full Blue Book List here

Listing 12.00 Mental Disorders (Mental Illness)
This category for Social Security Disability Benefits covers many conditions and is broken down into 11 sub-categories. All of the categories are evaluated by a complex system to determine the severity of the mental disability and how greatly it impacts the person’s life, education, social interactions, and ability to perform work functions in a variety of settings. The mental disorders that are included in the 11 subcategories for this category are:

  1. Neurocognitive disorders
  2. Schizophrenia and psychotic disorders
  3. Depressive Disorders such as bipolar and related disorders
  4. Intellectual Disorders
  5. Anxiety and Obsessive-Compulsive Disorders
  6. Somatic Symptom and Related Disorders
  7. Personality and Impulse-Control Disorders
  8. Autism Spectrum Disorder
  9. Neurodevelopmental Disorders
  10. Eating Disorders
  11. Trauma- and Stressor- Related Disorders

View full Blue Book List here

Listing 13.00 Malignant Neoplastic Disease (Cancers)
While many different types of cancer will qualify you to receive benefits, your approval process for benefits will depend on the type, stage, location and how well your cancer is responding to, or expected to, respond to treatment.  The SSA will also look at how long you are expected to be receiving treatment and if you would be able to return to work. Some of the common cancers that will qualify for SSD benefits are Leukemia, Lung Cancer, Colon Cancer and Cervical Cancer, just to name a few. View full Blue Book List here

Listing 13.00 Malignant Neoplastic Disease (Cancers)
While many different types of cancer will qualify you to receive benefits, your approval process for benefits will depend on the type, stage, location and how well your cancer is responding to, or expected to, respond to treatment.  The SSA will also look at how long you are expected to be receiving treatment and if you would be able to return to work. Some of the common cancers that will qualify for SSD benefits are Leukemia, Lung Cancer, Colon Cancer and Cervical Cancer, just to name a few. View full Blue Book List here

The Next Steps

If you believe you qualify for any of the above disorders, you will need to provide evidence of the disability and your financial records to qualify for benefits. Additionally, each disability benefits option has several criteria that determine which individuals can qualify for coverage from either program.

For SSDI applicants, you must be younger than 65 and have earned some work credits to qualify for this insurance. Each work credit has value calculated annually, and the value can change every year. For instance, in 2019, a single Social Security work credit cost $1360. You need more work credits to qualify for benefits the older you are.

Those 31 years of age and older must have earned 20 credits in the last 10 years before becoming disabled. Those between the ages of 24 and 31 must have worked half the years since turning 21.

For SSI benefits, your assets cannot exceed $1600 in total and you may only have a low income. The income limit is based on the federal benefit rate (FBR). This can change each year. In 2019, it was $771 per month for an individual.  Thus, in 2019, you cannot earn more than $771 per month to qualify for SSI.

Summary

Determining whether you qualify for SSD or SSI coverage for your disability or injury can be difficult. Fill out your information on our form and take the first steps to contact a local attorney and discuss the options for your case. With the right representation, you can present the strongest case and get the disability benefits you need for peace of mind.

Complete the Form for a Free Consultation With a Social Security Disability Attorney



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