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What Is Required for Someone to Be Eligible to Make Social Security Disability Insurance Claims?
There are two primary requirements for someone to be eligible for Social Security Disability Insurance (SSDI): The person must have worked long enough at a job covered by Social Security, and they must have a medical condition covered by SSDI.
Employment Requirement
SSDI requires applicants to work long enough and recently enough to earn benefits. This is not simply a matter of a certain number of years. Instead, Social Security calculates work credits based on total yearly income or earnings from self-employment, with a maximum of four work credits per year. The amount needed to earn a work credit varies every year. In 2025, $1,810 in wages or self-employment income earns one work credit, so once someone earns $7,420, they’ve earned four credits for the year and won’t earn more.
The number of work credits needed to be eligible for SSDI depends on the applicant’s age when their disability began. For most cases, the 20/40 rule applies. That means the applicant must have earned 40 credits overall, with 20 credits being earned in the ten years prior to the disability’s onset. There are some exceptions for younger workers. If you’re unsure of your work credit status due to your age, contact an experienced SSDI attorney.
Medical Eligibility
One thing that’s vital to understand about SSDI is that it pays only for total, permanent disability. Other disability programs may cover short-term or partial disability but not SSDI. Social Security’s definition of total disability has three points:
- The disability prevents the person from working at their substantial gainful activity level.
- The person can neither do the work they previously did nor become able to work at another type of job because of the disability.
- The disability has either already lasted or is expected to last for at least 12 consecutive months or lead to death.
How Does Social Security Determine if a Disability Qualifies for SSDI?
Several factors influence Social Security’s determination of whether or not someone’s disability qualifies them for SSDI. One is whether or not the applicant is earning income at or above the substantial gainful activity level, which would disqualify them.
Another factor is the nature of the disability. Social Security has a list of impairments it uses to determine whether a disability qualifies, with separate lists for adults and children. The lists are broken out into 14 separate components, with some variants between adults and children, but each list includes categories like cancer, immune system disorders, and mental and neurological disorders.
Tied to those conditions is the concept of “severe.” The disability must make the person unable to perform their job either at all or at a competent level.
If someone’s condition isn’t on the Social Security list but is found to be severe, it may be eligible for SSDI.
What Is the Process to Apply for a Social Security Disability Insurance Claim?
People can apply for SSDI online, by phone, or in person. Social Security will need several pieces of evidence and documentation to process your application, including your Social Security number, birth certificate, names and contact information for all medical personnel or facilities who have treated or advised you about your condition, your medical history related to the disability including all medications and lab test results, a summary of your employment (specifying the type of work you’ve done and where you’ve worked), a copy of your most recent tax return, and, if you’re a military veteran, your form DD-214.
Once you submit the application and evidence, it can take a long time to hear back, as Social Security will check every piece of documentation. You can check the status of your application online if you applied online or by calling Social Security if you applied by phone or in person.
What Happens if My Social Security Disability Insurance Claim Is Rejected
Unfortunately, it’s all too common for SSDI applications to be denied at first, with only about 20% approved. It’s disheartening to receive a denial when you’re sure your disability should qualify. However, there are still options at this point. If you haven’t already, contact an experienced SSDI claim attorney who can help you understand what the next steps might be.
There are some additional steps you can take, and your attorney can help you make these steps as clear as possible.
You can ask for reconsideration. This asks Social Security to review your application again and reconsider the reasons for the denial.
You can file an appeal. This would lead to a hearing in which you and witnesses can testify on your behalf before an administrative law judge, who would then rule on your case.
You can submit medical evidence. If your medical providers have additional information or records, you can submit them and ask them to be considered.
