Massachusetts
SSDI Lawyer

Knowing what SSDI is doesn’t automatically result in benefits. The challenge lies in proving to the SSA that your condition fits their extremely specific definition of disability.

According to the Social Security Act (specifically 42 U.S.C. § 423(d)(1)), “disability” means the inability to engage in any substantial gainful activity (SGA) because of a medically determinable physical or mental impairment which is expected to result in death or last for a continuous period of not less than 12 months.

Substantial gainful activity means working and earning over a certain amount each month. If you’re earning more than that, the SSA generally won’t consider you disabled.

Proving your impairment requires thorough medical evidence. Your word isn’t enough. You need detailed records, test results, and statements from treating physicians that clearly document your condition, its severity, and its limitations on your ability to function.

The SSA uses a rigid 5-Step Sequential Evaluation Process to decide claims:

1. Are you working? If you’re engaging in SGA, your claim is denied.
2. Is your condition severe? Does it significantly limit your ability to do basic work activities? If not, denied.
3. Does your condition meet or equal a Listing? SSA maintains a list (the “Blue Book”) of impairments considered severe enough to automatically qualify. If your condition matches or is medically equivalent to a listing, you may be approved.
4. Can you do your past relevant work? If your condition doesn’t meet a listing, can you still perform any job you held in the last 15 years? If yes, denied.
5. Can you do any other work? Considering your age, education, work experience, and your remaining functional capacity (Residual Functional Capacity or RFC), is there any other job in the national economy you could perform? If yes, denied. If no, approved.

This process, particularly steps 4 and 5 involving RFC, is where many claims run into trouble.