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Social Security Disability Eligibility

The Social Security Administration (SSA) uses strict criteria to evaluate Social Security Disability (SSDI) eligibility, including work history and medical conditions. For personalized guidance on your unique situation, consult our experienced Client Advocates.

Am I Eligible for Social Security Disability Benefits?

To be eligible for Social Security Disability Insurance (SSDI), you must satisfy specific requirements set by the Social Security Administration (SSA). These primary qualifications include:

  • 12 months

    Your illness or injury will prevent you from engaging in Substantial Gainful Activity (SGA) for a continuous period of at least 12 months, or be a condition expected to result in death.

  • 5 years

    You must have accumulated sufficient work credits by working and paying Social Security (FICA) taxes. Generally, this means you’ve worked for five (5) of the last ten (10) years. The exact number of credits needed varies with age.

  • Disabled Icon

    To be considered disabled by the Social Security Administration, your medical condition must be severe enough that it prevents you from performing your past work, and you cannot adjust to any other type of work that exists in the national economy.

Frequently Asked Questions

  • What is Supplemental Security Income? Should I apply for that too?

    Unlike SSDI, Supplemental Security Income (SSI) is a welfare program. SSI is a Federal income supplement program that is funded not by Social Security taxes but by general tax revenues. The program is designed to help aged, blind, and disabled individuals who have little or no income and provides cash benefits to meet basic needs for food, clothing, and shelter. If you have limited income and resources, you should also consider applying for SSI.

  • Will SSDI benefits also help me obtain health insurance coverage?

    Yes. You will become entitled to health insurance through Medicare 24 months after the date that SSA determines that you first became eligible for SSDI cash benefits. When you become eligible for Medicare, Aevo Insurance Services, a subsidiary of Advocator Advantage, can assist you with your health plan selection and enrollment process.

  • If I am awarded SSDI benefits, how long will I continue to receive them?

    You will continue to receive SSDI benefits as long as you continue to meet SSA’s definition of disability. SSA may find that you are no longer disabled due to medical improvement or if you return to work at a Substantial Gainful Activity level.

    You are required to inform Advocator Advantage and/or SSA of changes in your work status or if your health improves. This is necessary to avoid incurring an overpayment to SSA.

  • How much will it cost to have Advocator Advantage help me?

    Our fees are statutorily capped by SSA. Generally, we receive a percentage of your retroactive, lump-sum award, up to a maximum amount established by SSA. There are no hidden fees or costs associated with our services. We only earn a fee if we help you obtain an award, so you can be sure that we are working as hard as we can to get your claim approved.

  • How long will it take for SSA to process my application?

    Unfortunately, the process of applying for and being awarded SSDI benefits can be extremely long. Depending on the number of appeals needed to get your case awarded, the process can take anywhere from six months to three or four years. 

  • How long will it take to get my first check after I am awarded?

    It can take up to 60 days to receive your first check after you have been awarded. Processing time is generally faster at the initial claim and reconsideration levels, while it tends to take longer for clients who are awarded at the hearing level.

    SSA can delay the processing of a claim for many different reasons and will not release any benefits until all necessary documentation is in order. This may include a copy of your birth certificate, citizenship papers, representation payee documents, or proof of other public payments such as state disability or workers’ compensation. We will help you provide these documents to SSA in a timely fashion to avoid unnecessary delays in processing your monthly payments

  • When will my monthly benefits begin?

    If your application is approved, your first SSDI monthly benefit will be paid for the sixth full month after the date that SSA determined that you became disabled (Disability Onset Date). For example, if SSA finds that your disability began on June 15, 2021, your first monthly benefit would be paid for the month of December 2021. Social Security benefits are paid in the month following the month for which they come due, so the benefit due for December would actually be paid to you in January.

  • How will my benefits be calculated, i.e., how much will I get?

    The amount of your monthly benefit is based on your lifetime average earnings covered by Social Security and is reduced if you receive other government benefits, such as workers’ compensation – including Black Lung payments – or public disability benefits.

  • Can I receive SSDI benefits for my dependent children?

    Yes. Children up to 18, or those who have not graduated from high school, may be entitled to benefits if you become disabled. Generally, dependent children receive 50% of the amount of your monthly SSDI benefit, which is divided equally among all eligible dependents.

  • I am receiving long-term disability (LTD) insurance benefits. Will I automatically qualify for SSDI benefits?

    No. Receipt of private LTD benefits does not impact your claim for SSDI benefits. Likewise, if at some point your LTD benefits are terminated, the fact that you no longer receive LTD benefits would not have a negative impact on your SSDI claim.

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Do You Think You Qualify?

Even if you started the application process on your
own or with a different advocate, we can help.