Qualifying for Disability Benefits: Social Security Administration Criteria

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To qualify for Social Security Disability Insurance (SSDI) benefits, the Social Security Administration (SSA) evaluates several factors, including your work history, medical condition, and the severity of your disability. Understanding these criteria is essential for determining your eligibility.


Determining SSDI Eligibility


Are you working?
Naturally, your monthly income plays a huge role in determining your monthly SSDI payment. The first step of the Social Security review process is really very simple. While you are allowed to work a little bit and still claim to be disabled, the limits are fairly low. For 2025 the absolute most you can make per month before taxes is $1620. Above that and you are engaged in Substantial Gainful Activity (SGA) and they will not even look at your medical conditions.

Each year the SGA level goes up according to the cost of living. The SGA amount is higher for those who are blind. For example, SGA for statutorily blind people in 2025 is $2700.


Is this long-term?
To qualify for SSDI, your condition must have lasted (or be expected to last) at least 12 months and must significantly impact your ability to work.


Is your condition listed in the SSA’s Blue Book?
The SSA maintains a
Listing of Impairments (commonly referred to as the Blue Book), which outlines the qualifying criteria for various medical conditions. If your condition is not listed or does not meet the Blue Book’s criteria, and most do not, your case will be reviewed to determine if it is severe enough to prevent you from working.


Can you perform your previous job?
Your condition must prevent you from performing the work you did before. If you are still able to do your prior job, you will not qualify for benefits. The first thing the SSA asks is what is your residual functional capacity (RFC). Social Security will look at the jobs you’ve done over the last 5 years and make a determination, based on your RFC, as to whether or not you can do your past work.


Can you perform any other type of work?
Your medical condition must also prevent you from performing other types of work. The SSA evaluates your age, education, work experience, and skills. If you are able to transition to a different type of work, you will not qualify for benefits. Your age is a critical factor at this step since the older you are the harder it is to adapt. If you are 50 or older claims become significantly easier.


The Role of Work History and Income in Determining Eligibility

In addition to your medical condition, the SSA evaluates work history and income when determining eligibility for benefits.


SSDI Work Requirements
You generally need 40 work credits to qualify for SSDI. 20 of the 40 work credits need to be earned in the last 10 years ending with the year your disability begins. However, the younger you are when you become disabled, the fewer work credits you will need. 
The rules can get complicated. These are guidelines, and other factors may influence the exact number of credits needed.


SSI Eligibility
If you don’t have enough work credits for SSDI, you may still be eligible for Supplemental Security Income (SSI), which is based on financial need rather than work history. In order to receive SSI benefits, not only do you have to prove that you meet the medical requirements but you also have to meet the “non-medical” requirements. What is that? Money essentially. Since SSI is considered a type of welfare benefit, it has very strict and very low income and assets limitations. Those rules can also be complicated.


For more information or assistance with your application for SSDI or SSI, contact
Gordon & Pont to speak with an experienced attorney who can guide you through the process and help you understand your eligibility.

  • How do I know if I am eligible for SSDI?

    In order to obtain SSDI you must prove that you have a disability that qualifies under the Social Security Administration guidelines and you must have worked long enough and recently enough (earning work credits) to qualify for disability benefits.  The SSA definition of “disabled” varies depending on your age, education and work that you have performed within the last five years.


    According to the Social Security Administration, work credits are based on your total yearly wages or self-employment income. You can earn up to four credits each year. In 2026, you would have earned one credit for each $1,890 of wages or self-employment income. Therefore, if you earned $7,560 in 2026 you would have earned your four credits for the year. Generally, you need 40 credits, 20 of which were earned in the last 10 years ending with the year you become disabled. This requires that you have worked at least 5 of the last 10 years since SSDI credits do expire.  Younger workers may qualify with fewer credits.

  • What if the SSA denies my disability claim?

    Don’t worry.  The vast majority of initial disability applications are denied.  Gordon & Pont can help. After receiving a denial letter, you have 60 days to appeal. Our experienced disability lawyers handle every aspect of your appeal, from notifying the SSA to representing you in a hearing before an administrative law judge. There are four levels in the appeals process:


    • Reconsideration. A team not involved in the previous decision thoroughly reviews your claim, along with any newly submitted information, to determine whether you qualify for SSI or SSDI.
    • Disability hearing. If you’re denied disability benefits at the reconsideration level, we request a hearing with an administrative law judge (ALJ) who reviews all the available information, takes testimony from you and a “vocational” or jobs expert and issues their ruling. 
    • Appeals Council. If denied again by the ALJ, we ask the Appeals Council to review the ruling for legal errors.
    • Federal lawsuit. If you disagree with the Appeals Council’s decision, a lawsuit can be filed in Federal Court again asking that they review and correct any legal errors.
  • What is Substantial Gainful Activity (SGA)

    The SSA uses a five-step sequential evaluation process to determine if someone qualifies for disability benefits. The very first question they ask is: “Is the claimant engaging in substantial gainful activity?” If the answer is yes, the claim is typically denied, regardless of the person’s medical condition or functional capacity.  For 2026 SGA is $1690 per month before taxes.


    The SSA defines substantial gainful activity using two key components:


    1. Substantial Work: This involves performing significant physical or mental activities. The SSA considers even part-time work to be “substantial” if the duties are significant. 
    2. Gainful Work: This is work performed for pay or profit. The activity is considered “gainful” if it is the kind of work usually done for compensation, whether or not a profit is actually made. 
    3.  

SGA and Its Impact on Disability Benefits

For an initial application, engaging in SGA is usually immediately disqualifying. The SSA’s position is that if someone can perform work at the SGA level, they are not disabled. This is why the agency reviews work activity before it even considers the severity of your medical condition.


However, not all work activity qualifies as SGA. The SSA may disregard earnings from a short term work attempt that was unsuccessful due to the person’s medical condition. An “unsuccessful work attempt” (UWA) is a period of work that ends or is reduced below the SGA level after a short time (usually six months or less) because of the impairment.


Earnings Limits and SSA Guidelines

The most common way the SSA evaluates SGA is by looking at your monthly earnings. The agency sets an annual income threshold, and earning over that amount is generally considered evidence of SGA.


These figures are based on your monthly gross earnings, not your take-home pay and goes up every year. The SSA may deduct certain impairment-related work expenses (IRWEs) from your earnings when calculating your income for SGA purposes. An IRWE is an out-of-pocket expense for an item or service that you need to be able to work.


If you are self-employed, the SSA rules are far more complex. The agency will look not just at your income but also at factors like the hours you devote to the business and the nature of your duties to determine if your work activity is substantial and gainful.

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