How Does the Social Security Administration Define Disability?

William Lindahl, MBA, CLPF & Sara Toor, M.A

For Adults
For an individual to meet the Social Security Administration’s (SSA) definition of disability, an individual must not be able to engage in substantial gainful activity (SGA) due to a medically-determined physical or mental impairment that would result in death, or has lasted or is to last for a continuous period of at least 12 months.Determining if an Individual is Disabled
The Social Security Administration (SSA) utilizes a five-step process to determine if an individual is disabled. The five-step process is followed in a set order. If an individual is disabled or not disabled at a step, a representative makes his/her decision and he/she does not move on to the next step. If for some reason a representative cannot find that an individual is disabled or not disabled at a specific step, the representative will continue to the next step.

  1. Does the individual engage in substantial gainful activity? If no continue to next step; if yes, the individual is determined not disabled.
  2. Is the individual’s physical and/or mental condition severe?If Yes continue to next step; if no, the individual is determined as not disabled.
  3. Does the individual’s medical condition meet or equal the severity of a listing (SSA listing of medical criteria considered so severe that an individual is found to be disabled if individual matches them-blue book? If yes, the individual is determined as disabled and no need to continue to next step; if   no Residual Functional Capacity assessment to be performed at step 4 and step 5.
  4. If an individual retains physical and mental capacity to perform past relevant work he/she is determined not disabled. If no past relevant work can be performed, the evaluator/representative will go to step 5.
  5. Can the individual make an adjustment to any other work? If an individual can make an adjustment to other work when considering residual functional capacity, age, education, and work experience, then the individual is considered not disabled. If an individual cannot make an adjustment he/she is found to be disabled.

For Children
The Social Security Administration’s (SSA) definition of disability for children is a bit different than the definition they provide for adults. The Social Security Administration considers a child to be A person who is neither married (as determined by Social Security) nor head of a household and is under age 18; or is under age 22 and is a student regularly attending school (as determined by Social Security).

For a child, all the following requirements, must be met for a child to be considered disabled and be eligible for Supplemental Security Income (SSI) benefits:

  • The child must not be working or earning more than $1,170 a month in 2017. (This earnings amount usually changes every year.)
  • The child must have a physical or mental condition, or a combination of conditions, that result in “marked and severe functional limitations.” This means that the condition(s) must very seriously limit your child’s activities.
  • The child’s condition(s) must have been disabling, or be expected to be disabling, for at least 12 months; or the condition(s) must be expected to result in death.

For children applying for SSI, the process requires sequential review of:

  1. the child’s current work activity (if any),
  2. the severity of his or her impairment(s), and
  3. an assessment of whether his or her impairment(s) meets, medically equals, or functionally equals a listing (SSA bluebook).

Overall, there are various factors and facts the Social Security Administration considers when determining if an individual is disabled or not. If you believe that you, your child, or a loved one may qualify for benefits it would be best to reach out to your local Social Security Administration (SSA) Office in your area. If you are unsure of the contact information for your local office, visit https://secure.ssa.gov/ICON/main.jsp to obtain the office information.

DISCLAIMER: The information provided by CPT is for informational purposes only and is intended to be used as a non-legal guide prior to consultation with an attorney familiar with your specific legal situation. CPT is not engaged in the practice of law or in rendering legal advice or counsel. No such legal advice or counseling is either expressly or impliedly intended. This form is not a substitute for the advice or counsel of an attorney. If you require legal advice, you should seek the services of an attorney. © 2017 CPT All rights reserved.

Resources/Further Reading:
https://secure.ssa.gov/ICON/main.jsp
https://www.ssa.gov/disability/professionals/bluebook/general-info.htm
https://www.ssa.gov/ssi/text-child-ussi.htm
https://www.ssa.gov/oidap/Documents/Social%20Security%20Administration.%20%20SSAs%20Sequential%20Evaluation.pdf
https://www.ssa.gov/disability/step4and5.htm
https://www.ssa.gov/redbook/eng/definedisability.htm
https://www.ssa.gov/disability/professionals/bluebook/
https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm
https://www.ssa.gov/disability/professionals/bluebook/ChildhoodListings.htm