“Incapacitated” and “disabled” largely carry the same definition when Social Security is determining whether to approve or deny a disability application. In general, a person is considered incapacitated if they been unable to perform non-substantial work for at least the past 12 months. Alternately, if the Social Security Administration thinks your disability allows you to do “substantial gainful activity” that allows you to earn a living wage, they will claim you are not incapacitated and deny your application for SSDI or SSI.
What are the SSA Criteria for Defining Incapacitated or Disabled?
Disability benefits are typically approved if you:
- Cannot do the kind of work you did before becoming disabled. For example, if you were a factory machine operator for 20 years and had a heart attack that reduced your ability to operate a machine or perform other similar work, you would probably be approved for SSI or SSDI.
- Have a medical condition lasting for 12 months continuously
- Have a medical condition that is expected to eventually result in death
Special guidelines apply regarding criteria for SSA benefits if a claimant is blind, a disabled child, a widow/widower or a wounded veteran. Call Joel Thrift Law today for assistance with applying for disability benefits. We can help significantly increase your chance of being approved for monthly benefits without having to appeal a denial.
What is Substantial Gainful Activity?
If the SSA thinks you can do substantial work (gainful) activity, that means they think you can work part-time or full-time at jobs that pay you an income equal to or less than the pay you received before becoming disabled.
However, even though you may be capable of working part-time due to your medical condition, that does not mean you won’t qualify for disability benefits. As of 2019, if someone earns over $1220 each month but is deemed incapacitated by the SSA, they may still be approved for disability benefits. For people who are blind, the income limit is $2040.
Recipients of SSDI can work for a trial period that allows them to receive the full amount of their benefits while earning income. Currently, the Social Security Administration considers a trial working month as one that provides at least $880 in income. Following this nine-month trial period, you may still continue receiving SSDI for three years (36 months) as long as your income is below the substantial gainful activity level. If you earn over $1220 in any given month, you forfeit disability payments for that month.
What Medical Conditions are Considered to be Automatically Incapacitating?
The SSA has a “Compassionate Allowance” list of medical conditions that requires applicants only provide a doctor’s diagnosis of the condition. No other documentation is necessary to be approved for benefits. Diseases and disorders on the Compassionate Allowance list include:
- Stage IV breast cancer
- Acute leukemia
- Gallbladder cancer
- ALS (Lou Gehrig’s disease)
- Alzheimer’s disease
- Inflammatory breast cancer
- Pancreatic or liver cancer
- Lung cancer (small cell)
- Thyroid cancer
Does the SSA Consider Mental Disorders as Incapacitating Disorders?
Yes. However, proving to the SSA that you have a psychological disorder disabling enough to prevent you from working is more difficult than proving a physical disability. If you are applying for disability because you suffer from severe anxiety, depression or bipolar disorder, you will need to submit numerous, detailed documents composed by licensed healthcare professionals. Treatment summaries must be from psychiatrists, psychologists and licensed therapists who have been seeing the claimant for at least one year. Hospital and emergency room records (if applicable) are also essential for proving an incapacitating mental health issue. More importantly, evidence should also show that the mental illness is preventing the disability applicant from obtaining gainful employment.
If you are preparing to file a disability claim with the SSA but your medical problem is not on the Compassionate Allowance list of conditions, contact Joel Thrift Law today to schedule a consultation appointment. We can help strengthen your claim and reduce the risk of being denied due to errors and insufficient documentation.