Under the U.S. federal insurance program, individuals can receive compensation if they are unable to work because of a disability.
However, certain requirements must be met before applicants can obtain compensation.
The inability to perform “substantial gainful activity”
In order to qualify for disability benefits, the law states that applicants must have a severe impairment—either physical or mental—that prevents them from being able to perform what’s referred to as “substantial gainful activity.”
Understanding the SGA requirement
Substantial gainful activity, or SGA as it is referred to, is “the performance of significant duties over a reasonable period of time for certain amount of pay or profit.”
In other words, if a person can work and earn above a certain amount (e.g. over $1170 per month as of 2017) due to a disability, then they are able to perform substantial gainful activity and would not qualify for disability compensation.
Alternately, if individuals cannot work or cannot earn more than the stipulated amount due to their disability, then they are prevented from performing substantial gainful activity.
Providing detailed medical information
However, applicants must provide medical records that show evidence or documentation of their disability and how it prevents them from working. Information provided is evaluated by an examiner with the Social Security Administration who will assess the case and determine qualification.
Automatic approval of benefits
In some situations, applicants will automatically be awarded benefits (or awarded compensation more quickly) if their physical or mental condition is extremely severe and likely to be permanent or result in death.
The Social Security Administration has a detailed list of these types of conditions under the Impairment Listing Manual, also known as the blue book. The list is updated each year.
Some conditions include neurological disorders, including Parkinson’s or epilepsy, cancer, and immune system disorders, such as HIV/AIDS or lupus.
Getting legal assistance
The application process is extremely multifaceted with strict guidelines and requirements. It is not uncommon for many individuals to be denied benefits at first.
Getting the assistance of a Social Security Disability lawyer who can offer step-by-step guidance in filling out the initial application is likely to increase the chances of success.