Qualifying For Disability Benefits As An Adult

Qualifying For Disability Benefits As An Adult

Social Security benefits are available through the Social Security Disability Insurance (SSDI) program to people who cannot work because they have a medical condition expected to last at least one year or result in death. Adults must meet a very rigid definition of disability to qualify for these benefits. While some programs provide benefits to people with partial or short-term disabilities, the SSDI program does not.

While a disabled child or young adult may have income low enough to qualify for SSI (Supplemental Security Income), Social Security Disability Income benefits may result in greater benefits. Qualifying for SSDI also opens the door to other benefits. After 24 months of SSDI eligibility, a beneficiary qualifies for Medicare benefits. Another benefit is the Ticket to Work Program which increases opportunities for SSDI beneficiaries to obtain employment, vocational rehabilitation, and other support services from public and private providers, employers, and other organizations.

If a person applies for benefits on or after the first day of the first calendar month after they turn age 18, the disability decision is determined using the disability rules for adults rather than for children. An adult (18 and over) must have a medically determinable physical or mental impairment(s) that results in the “inability to do any substantial gainful activity” and can be expected to result in death or has lasted or can be expected to last at least 12 months.

To qualify for disability benefits, an applicant must have enough work credits. However, it is crucial to note that adults with disabilities who do not have enough work credits may use, under certain circumstances, their parents’ work credits to qualify for SSDI benefits.

Disabled adult children may qualify for disability benefits under the work history of a parent, or in some cases a grandparent. (Sometimes referred to as DAC benefits or more technically Childhood Disability Benefits).  An adult child may receive benefits using the earnings history of one of the following:

  • *A biological parent,
  • *An adoptive parent,
  • *A stepparent,
  • *An adoptive grandparent, or
  • *A grandparent who is otherwise the adult child’s legal guardian.

The Social Security Administration (SSA) considers someone a disabled adult child if the following criteria are met:

  • *The applicant is over the age of 18
  • *The applicant is not married
  • *The applicant has a disability that began before the age of 22, and
  • *One of the applicant’s parents receives Social Security benefits or is deceased but at the time of death was eligible to receive Social Security benefits.

While a young adult generally must have some work history to be eligible for SSDI, young adults require fewer “credits” to qualify for SSDI benefits. These two different earnings tests are the following:

  1. A recent work test, based on the applicant’s age at the time the applicant became disabled.
  2. A duration of work test to show that the applicant worked to receive sufficient work credits under federal law.

The number of credits necessary to meet the recent work test depends on an applicant’s age and is subject to the following rules:

  • Before age 24 – An applicant may qualify with 6 credits earned in the 3-year period ending when the applicant’s disability begins.
  • Age 24 to 31 – – In general, applicants may qualify if they have credit for working half the time between age 21 and the time the disability began. For example, if a disability is developed at age 28, the applicant would need 3 years of work (12 credits) out of the past 6 years (between ages 22 and 28).
  • Age 31 or older – In general, an applicant must have at least 20 credits in the 10-year period immediately before the disability began.

*How the SSA Decides if an Applicant has a Qualifying Disability

The Social Security Administration (SSA) considers an applicant to have a qualifying disability under Social Security rules if all the following are true:

  • The applicant cannot do work and engage in substantial gainful activity (SGA) because of the applicant’s medical condition.
  • The applicant cannot do work previously done by the applicant or adjust to other work because of the applicant’s medical condition.
  • The applicant’s condition has lasted or is expected to last for at least one year or to result in death.

The SSA maintains a list of medical conditions for each of the major body systems. The conditions on this list are those that the SSA considers severe enough to prevent a person from doing SGA. If an applicant’s condition is not on the list, the SSA then considers if the condition is as severe as a medical condition on the list. If so, the SSA will find that the applicant has a qualifying disability.

If the SSA does not find the condition to be severe as one on the list, it next considers if the applicant’s medical impairment(s) prevents the performance of any past work. If it does, the SSA next considers if there is other work the applicant could do despite the medical impairment(s). In sum, the applicant’s disability must be a listed impairment, equal a listed impairment, or cause the applicant to have limited functional capacity.

Ultimately, the SSA considers an applicant’s medical conditions, age, education, past work experience, and any transferable skills. If the applicant cannot perform other work, the SSA will approve eligibility for disability benefits. If the applicant can do other work, the SSA will find that the applicant does not have a qualifying disability and deny the claim.

While the SSA may take several months to process an application, benefits may be paid retroactively up to five months before the application was filed. Adults who are receiving SSDI benefits when they reach full retirement age will have their disability benefits automatically converted to retirement benefits, although the benefit amount remains the same.

Rubin Law is a law firm solely dedicated to enhancing the lives of children and adults with intellectual disabilities, developmental disabilities, and mental illnesses. Rubin Law is the only law firm in Illinois that limits its practice to providing legal services and future planning for adults and children with special needs. We offer patience, compassion, and a unique understanding to those with disabilities and those who care for them. Rubin Law offers specialized guidance to those who want to provide for their child’s future needs with the expertise to help you accomplish all your specific goals. For more information, please email us at email@rubinlaw.com or call 866-TO-RUBIN.