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What is disability according to Social Security Disability law?

By   /  March 3, 2016  /  97 Comments

Learn about disability as defined by the Social Security Administration and see how working while disabled fits into getting Social Security disability.

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what-is-disability

Watch the video: “What is disability according to Social Security Disability law? “

How Social Security Defines Disability

For adult claimants, including disabled adult children, the Social Security Administration, known as SSA, answers the question “What is disability?” with the following definition: “[Disability is] the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted, or can be expected to last, for a continuous period of not less than twelve months.”

Work and Social Security Disability

As you see, the definition is made up of several requirements, but before we go into detail about what each part of the definition means, we’d like to point out that it is often difficult to tell whether or not work that you performed after the date you claim disability will prevent you from being approved. Sometimes the only way to know for sure is to file a claim; however, you may also find it helpful to talk with a lawyer who is experienced in Social Security Disability claims.

More about SSA’s Definition of Disability

Now for a closer look at Social Security’s definition of disability. The definition contains several special terms that have legal definitions. For example, substantial gainful activity, abbreviated as SGA, is work activity that the Social Security Administration determines is “substantial” and “gainful.”

“Gainful” work is work performed for pay or profit, or a type of work that is generally performed for compensation, or work that is intended to result in a profit, whether or not you have a profit. This means that “gainful” is not always defined just by the amount you earn. Substantial gainful activity is determined differently for employees, for self-employed individuals, and for the blind.

For employees, there is a dollar amount that serves as a general guideline for substantial work. The amount has increased over the years, due to inflation. In 2016, monthly gross earnings of $1,130.00 or more are generally defined as substantial for non-blind workers. The SGA guideline for blind workers is usually $1,820.00. However, for the self-employed and sometimes even for employees, additional factors can apply when the Social Security Administration assesses whether a person is performing SGA.

The SGA assessment for self-employed workers is even more complex than for employees. For example, the work of blind, self-employed workers is evaluated considering “countable” earnings; however, under Social Security rules, some types of income earned by a blind person are not counted when assessing whether the work is substantial.

This discussion of Social Security’s definition of disability provides an overview answer to the question “What is disability?” For a discussion of how this definition is applied to your Social Security Disability claim, visit our article “How Does the Social Security Administration Apply Social Security Disability Laws to Determine If I Am Disabled?”

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97 Comments

  1. Roxanna says:

    Im waitin on a court date sense dec2015.im diagnosed with ptsd.major dipression with syckotic featers.take busporin sertralin and lutura.filed for disability in jan 2015.been goin to therapy every week and takin my meds.dont have a work history iam 47 yrs old below .left school first month of ninth grade.was in special ed .have affects from the meds do you think i will be approved a attorney took my case now were waitin for the court date

    • Kay Derochie says:

      Dear Roxanna,

      You have a possibility of being approved. The attorney would not have taken your case if he or she didn’t believe there was a reasonable chance of approval. However, you won’t know until you have the hearing and get the hearing decision letter.

      Sincerely,
      Kay

  2. cori says:

    I’m 47, my husband passed 8 yrs ago June , 6, 2008. I was denied spousal death benefit because I made to much money but our two children were approved until age 18. I have lupus, fibromyalgia , hashimotos desease and in the last two years severe depression. I have been having issues with what is listed for the past two years, I am on fmla intermenent and have exausted my sick and vacation so if I’m out I am being docked and my checked is very short which does not help mydepression since I am a single parent with kids, the stress triggers my lupus to flareup and fibromyalgia pain so it is a constant cycle. I have been considering going on medical leave to short term, to longterm and once on longterm I can draw from my state pension and my work will pay my health insurance up to two years because of my 15 years I have worked. Can I draw my state pension and still get social security? Is so, would it be better to retire because of my disabilities and apply for social security. How would my widow benefits apply or help me. I believe if I am able to take the time to concentrate on my illness and take time to get the treatments needed to get to what 100% is for me that I can live with with minimal pain and get my depression and anxiety under control, I can return to work a healthy person and work until retirement age. I’m getting information from my work that it is in my best interest to retire early and my family saying to go out on leave where I can return to a job. It may not be the same position but one equal to my level and pay.

    • Kay Derochie says:

      Dear Cori,

      I cannot tell you what is best for you to do: apply for STD and Social Security or take your pension and apply for Social Security. I can provide some information. Your situation touches on several factors:

      1. If your wages from the state are taxed for Social Security, you will be insured for Social Security Disability benefits (SSDI). If they have not been taxed (no FICA taxes withheld from your paychecks), you are not insured for Social Security unless you were working a second taxed job.

      2. If you are insured and you expect to be disabled for a period of twelve months, you can apply for Social Security Disability (SSDI) as soon as you stop work or now if you are grossing less than $1,130 a month. You can receive short-term disability (STD) and long-term disability (LTD) benefits while you wait for a Social Security decision and even while receiving SSDI, although the STD and LTD would likely be reduced for the SSDI.

      3. If your wages have been taxed for Social Security and you are insured, you can receive SSDI and the state pensions withhout any offset (reduction).

      4. If you receive SSDI and your health improves somewhat but you have not clearly recovered for a successful return to work, you get a Ticket to Work and may be eligible for a nine-month Trial Work Period during which SSDI benefits are paid in full while you try to reestablish yourself in the workplace. You can read more about return-to-work incentives in the Red Book, which is available online at http://www.ssa.gov and in local Social Security offices.

      Sincerely,
      Kay

  3. Latoya says:

    I have a chronic eye disease in both eyes in which I was diagnosed in 2008. It is treatable but no cureable. It had progressively gotten worse and does well but flares back up. It causes blindness and I haven’t worked since February 2016. Applied for disability but it just says medical records being reviewed. What are my chances of approval?

    • Kay Derochie says:

      Dear Latoya,

      If you are legally blind, your claim will be approved. If you are not legally blind, you may be eligible based on low vision and/or other symptoms associated with the disease. In the latter case, your eligibility will depend on whether your limitations keep you from working in any occupation for which you would be qualified if you did not have your vision limitations.

      Sincerely,
      Kay

  4. Denise says:

    I have been suffering from depression for a while now. I have been experiencing panic attacks, insomnia and I cant lay or sit long what has finally been diagnosed as peripheral neuropathy after almost 2 years of checking with physical therapy, having MRIs, x-rays and now waiting to see a neurologist. I have been out of work since January waiting to see if Hartford will approve my long term but I am still waiting. I am going to a therapist for my depression and now they want to send me to partial hospitalization. Will I qualify for disability I don’t think I can function long anymore?

    • Kay Derochie says:

      Dear Denise,

      As you describe your health, you may qualify for Social Security Disability (SSD) benefits. I suggest that you file an application now because there are several benefits to filing both claims. If you are approved, let The Hartford know that you have been approved. If you are denied either benefit, appeal with the help of an attorney.

      Sincerely,
      Kay

  5. Sharavia moore says:

    I have been dealing with depression since adolescence..i never wanted meds and tried to maintain a healthy life no matter my issues..however these last couple years I have noticed my depression and Bipolar disorder play a major role in my personal life,work,parenthood,everything. I find as of late that i care about nothing,I eat maybe once a day,I call out constantly because I wake up angry or aching from my spondylolsis..I feel I was never given a fair chance at life because I am not supposed to be here.but fact is is I have kids and at the very least would like to provide for them..workimg full-time is an extreme mental and physical struggle. If I am denied yet again what can/should I do?

    • Kay Derochie says:

      Dear Sharavia,

      If you do not already have an attorney assisting you with your claim, I suggest that you hire an experienced Social Security attorney to help present your case. When you hire a Social Security attorney, you do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge, and the Social Security Administration pays the attorney directly from your retroactive award before they send your back pay to you.

      Sincerely,
      Kay

  6. I have been fighting disability since 2009 due to breaking my arm and shattering my wrist and now having a titanium wrist arm and wire and web and Nash gland my hand my hand has no mobility chronic pain constantly and doesn’t do much of anything this is a big disability and doing anything I also have but I have just by weeding and time going on I have A torn rotator stuff I had my like a third of my like ripped out but I lost my nerves my muscles ligaments planter Fisher Titus nerve damage sciatica that is severe that also causes the bottom my feet to go into excruciating pain I have carpal Tonnele on my right hand which does not seem like a very big deal to me it doesn’t but I have compression fractures in my spine I had C diff from all the antibiotics I also have diverticulitis colitis , ulceralative colitis, poor bone density ,known by a test . Dr felt caused not only by A hysterectomy but also now nutrition I believe more than seven times in one year from the stomach issues and me not being able to eat do to me needing my hands to make something TE and that caused too much pain and when I’m into much pain I can’t eat and when I have any of these colitis is for C diff the food does not stay and up with dehydration among other problems like mom education I have compression fractures I have bulging disc herniated disc degenerative disc disease 2014 I broke my foot I broke my heel and I broke my ankle in several places and it up with more screws The screws were working themselves out so the doctor had to take them out but he had to do an MRI first to see if they were healing so I have a records from them our ice dating my bones have healed as much as are going to heal and are non-further feeling ever I have been homeless for five years going from place to place staying in one place the longest still going to other places I’ve been through all the shelters they didn’t want me there it wouldn’t let me stay because I’m disabled I’m not a drug attic to the judge when I did my hearing the judge was the toughest and a The one who told everyone and anyone know but due to my records and the fax I didn’t see how I could lose but I did my attorney and information from 2012 and did not turn them into 2014 year I broke my foot there so much I don’t see why my attorney held onto a lot of serious information for two years and then turned and then before we went to court now I have been turned down I found out that I did not have an attorney and court Mike I thought I did I had a advocate never opened his mouth my titanium arm was never brought up about me being able to work with that arm which I cannot this is even affected my heart at this point I have a chronic anxiety disorder sleep disorder PTSD panic attacks I’m bipolar also now I got turned down but my I recently fired my advocate because they want to wait for another hearing instead of going through the having another just look at it three different ways and I’m at my final disability before I have no more work history behind me when I work since I was 14 I don’t know what to do at this point here I am at hearing review this what I want I review the advocate did put in for that but kept saying that they did not get their CD that they were waiting on but they have already used ice use in the past years and turned and material late due to that seems to things they do hurt me because they want to go back to court so they can make more money I don’t know what to do please help me my wreckers speak for themselves and I just have more and more going on in such chronic depression it’s hard to get up and do anything ortrust in what I might do . They say to send them that you want a review and I letter and send in new records or anything I’d like them to look at well I compiled all my papers going to go to my primary doctor and have him put it all in one functional report and letter because he wants to see me get my disability otherwise he feels that I will not make it much longer and I’ve had three other doctors right that same whether to saying I won’t make it much longer I will die and one saying our decompose if something doesn’t happen soon for me with all my medical issues it’s been hard to keep up with going to all the doctors all the time because of have to have a doctor for every single part of my body amateur The judge managed to completely twist turn everything upside down like she could not add 2+2 you would think I was in shock seeing all that and I can show report and explain every single thing that she said to turn me down but do not know what to do I’m I know I need an attorney to represent me but an attorney and advocate and I don’t know what mine was trying to do to me except make more money so I did fire them I only have a few days left of the 60 days to write my letter to ask for more time to be able to find a new attorney can you tell me anything I should do Please understand this was voice writing on my iPad so I hope you’re able to understand please give me some advice

    • Kay Derochie says:

      Dear Doreen,

      File the request for an Appeals Council review on your own to be sure you file within the appeals period. Do not try to make a case for the appeal. Say that you are trying to find an attorney and expect to have an attorney soon and that the full brief for the appeal will be submitted by the attorney within about one to two months. (Appeals Council reviews are backlogged so the delay should not be a problem.) Then look for someone who has experience in Appeals Council reviews and discuss the errors you see in the judge’s decision with the attorney. Note that in most cases, new evidence cannot be submitted because the review if to see if the judge made an error based on the information the judge had at the time of the hearing.

      Sincerely,
      Kay

      Sincerely,
      Kay

  7. sammy t says:

    I am 59 year old male. I am a grocery store mgr and I work 50 to 60 hours a week,a job I have done for 35 years.i was diagnosed with parkinsons 5 years ago,and have slowly gotten worse. I have extreme rigity in my right side and I find it extremely difficult to do the simpliest things such as writing.using a computer mouse .etc,,all that said.2 years ago I had total knee replacement. I enjoy workind but can no longer work the hours required as a mgr. if I step down to another position I would also take an extreme paycut,which I cant afford to do,what are my chances of getting disability and maybe workin part time.if that is allowed.i certainly cant afford to quit work while tryin to get approve

    • Kay Derochie says:

      Dear Sammy,

      You can apply for Social Security if you are working and earning less than $1,130 gross a month. If you have to stop work or change to a different substantially less compensated position, I suggest that you check with your employer to find out if you are covered by a company-sponsored short-term disability policy that could provide income while you a Social Security claim is processed and during the first five full-calendar months of disability that are not paid by Social Security. If not, check to see if you live in one of the states that has a short-term state disability insurance.

      Sincerely,
      Kay

  8. BOB says:

    My mother will become U.S citizen this year but she never had job. She has disability. She can’t read or write and also have memory problem. I need to know, since she never worked in U.S, does she qualify for SSI?

    Thank you

  9. Teri says:

    I am on SSDI and tired too work after 3 years I lost 2 jobs in the last 3 month period. Iam now working again and was told I can make 1130 a month above my ssdi. Iam worried as I have to survive on my own. I do go to a therapist and a shrink for meds that I pay for. I go 2 times a month. This I feel is my last chance at working as I lost my other 2 jobs. I have severe anxiety attacks and panic disorder Iam bipolar and ptsd and have mood disorder been hospitalized in the mental part of the hospital four times due to not wanting to live. The 1130 a month is that also calculated in a year format for the year we are in? someoen told me to multiply 4.333 which doesnt make sense to me and I dont want to lose my ssdi and social security nver said anything about this. What does the 4.333 mean and what do I do. I called social security to let them know I started a job at the school cleaning but she didnt put it in my file and I was on hold over 20 minutes.If I was able to hang on to my partime cleaning job for 3 years does that mean I will lose my social security if Im still making less than the 1130?

    • Kay Derochie says:

      Dear Teri,

      Currently Substantial Gainful Activity (SGA) is typically defined as $1,130 a month. If your health has not improved substantially so that you have recovered medically, you can work and earn any amount during a nine-month Trial Work Period (TWP) during which full Social Security Disability benefits will be paid. The nine months can be sequential or scattered. After that for the next thirty-six calendar months, you will be paid full benefits for any month you do not perform SGA (now typically $1,130). If you earn $1,130 gross or more in a month, your payment will be suspended for that month. After the thirty-six month Extended Period of Eligibility, your benefits will terminate and your claim will be closed the first month that you perform SGA.

      With regard to the 4.333 weeks, the average number of weeks in a month is 4.333. Most pay periods are weekly or bi-weekly (every other week). If you are paid weekly, every three months you will get a fifth paycheck; if you are paid by weekly every six months you will get a third paycheck. These “extra” paychecks can result in your being paid at or above the SGA level even though you did not work at the SGA level in any month. To get the amount you actually earned in each month (assuming your work schedule was regular), you would take one week’s pay and multiply it times 4.333 weeks. Or you can prorate down to the daily rate and multiply the daily rate times the exact number of days worked in each month. If Social Security says that you performed SGA in months that you were paid an “extra” check, you may have to do or ask them to do this calculation to prove you did not perform SGA.

      Sincerely,
      Kay

  10. Patty says:

    Hi Kay, thank you for all you do on this site! Here’s my situation: I’m 53, will be 54 in October. I’ve worked in the insurance and financial services field most of my career working my way up to a stockbroker supervisor. I have an Associates Degree in Secretarial Science and am short about 6 credits to complete my Bachelors in Business Administration (I stopped my education a few years ago when my father got ill).

    I have been under continuous care after being diagnosed with depression, anxiety and panic attacks since the mid 1990’s. I have been put out of work by my doctor a couple of times after starting treatment- never hospitalized.

    Things really got bad when I was fired from my position as a stockbroker supervisor in 2008 along with 4 other employees as I was middle management (they fired one of my brokers, my boss, his boss). I had a strong case for wrongful termination but not the deep pockets my employer possessed. Ever since then, I’ve bounced from job to job, never staying more than a year or two.

    The anxiety and depression have worsened the last several years and early this year my dr realized that I am bipolar and suffer from manic depression. This was after I thought I was having a heart attack and was taken to the ER. It was diagnosed as a severe panic attack and further probing from my psychiatrist revealed the bipolar diagnosis. (I’ve learned to be a great actress and tried to never let others see my perceived weaknesses. No one knew how bad it was, not even my husband of 28 years realized the depth of things until I finally opened up).

    While it’s always been hard for me to be in crowds..almost agoraphobic at times, the bi polar is really bad. My psychiatrist has changed my meds several times and I’m now on high doses of 4 different meds that take the edge off, but many of the symptoms remain. I’ve not worked since Feb 2016 when my psychiatrist put me out of work for a month and I subsequently quit/fired from my office manager position.

    I filed for SSDI in March and in the last couple days had a physical exam and then a mental exam. I’ve looked at the grid and I’m confused. With my level of education it says I would be denied; however, I can’t even function some days from the meds and lack of sleep or exhaustion. I’ve tried retail in the past, the constant people interaction is too much for me. I was very honest and open with the Disability Psychiatrist. I truly don’t know what I can do for employment anymore and this comes from someone who started working Summer’s at the age of 9 and never stopped.

    I’m sorry for the dissertation here…I’m wondering what you think my approval chance might be based on your experience? I know that I will never be able to do any of my previous type of work. Frankly, I doubt I’ll ever return to the workforce. Just looking at job postings start my heart racing and takes me into an attack.

    Again, thank you for taking the time to read and comment. I truly appreciate all you do on this site.

    Patty

    • Kay Derochie says:

      Dear Patty,

      If your illness is sufficient to be considered severe, the amount of education you have and fairly high-level work experience will not keep you from being approved. If you are denied, I recommend that you appeal with the assistance of an experienced Social Security attorney. When you hire a Social Security attorney, you do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge, and the Social Security Administration pays the attorney directly from your retroactive award before they send your back pay to you.

      Sincerely,
      Kay

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