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Do I have to be dead or dying to get SSDI?

This is one of my favorite questions we get from SSDI applicants about the disability process. It can be asked tongue in cheek or with a general inquisitiveness of the level of impairment that is considered disabling according by the Social Security Administration (SSA).

How disabled is disabled enough to get disability benefits?

One misconception that many claimants have is that they can have a short-term or a partial disability to get SSDI. Unfortunately, unlike workers compensation or VA disability which provides a disability ranking to applicants and pays accordingly, the SSA only pays claimants a monthly, cash SSDI payment if they consider the claimant 100% disabled. This is why a very serious car accident injury, which leaves the victim incapacitated for months (but not 12 continuous months) can be denied by the SSA. Although the claimant may be 100% disabled at this point in time, often the SSA will argue that they will be able to recover and return to work prior to 12 months and their injuries are considered “short-term.”

Claimants who have been awarded SSDI but who later become much more injured or disabled also will not be allocated any more money for their conditions. Why? Because the SSA had already determined they were 100% disabled and agreed that they could not work. Any additional injuries will not increase their disability payment because they are currently receiving the maximum amount they are qualified to receive.

How do I know if I am disabled?

So do you have to be dead or dying to get SSDI benefits? The answer is no. Many claimants are considered disabled and have a condition or disease which is not likely to kill them or which is not terminal.

Many claimants do not realize that the SSA maintains a list of all the conditions and related symptoms they consider disabling on the Social Security Administration’s Listing of Impairments. This listing, also known as the SSA Blue Book, contains disabling conditions and symptoms which makes it impossible for SSDI claimants to continue to perform substantial gainful activity.

I recommend that all SSDI claimants who have been diagnosed with a condition review the SSA Blue Book to determine if their condition is listed, and if so, what symptoms they need to have documented and verified through medical tests or specific evaluations to meet a listing.

Claimants who have a condition which is not on the list will have to prove that their condition “meets or exceeds” a condition on the list or does not allow them to perform work.

Unfortunately, the listing is not conclusive and does not contain many common conditions that can be disabling. Talk to a disability lawyer if your condition is not on the list and you need information about medical documentation to prove you are disabled.

What if I have a terminal condition?

What if you do have a terminal condition? Fortunately, the SSA has a process in place to expedite the disability determination process for terminal cases. These cases will receive special handling, labeling, flagging and tracking to ensure they are processed as quickly as possible. Common terminal cases can include: AIDS, ALS, bone marrow transplant cases, any malignant cancer that is metastatic (stage IV), and small cell or oat cell lung cancer.