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Does someone need a specific diagnosis to receive SSDI benefits?

On Behalf of | May 22, 2024 | SSDI

Working adults contribute funds to the Social Security Administration (SSA) every time they receive a paycheck. Even independent contractors make routine Social Security contributions throughout their working lives. They can then potentially request retirement benefits when they leave their full-time employment later in life.

A small percentage of adults may find themselves unable to work before they reach retirement age. Medical challenges can potentially prevent someone from maintaining gainful employment. Those with health issues that directly affect their ability to work a job can sometimes qualify for Social Security Disability Insurance (SSDI) benefits until they reach retirement age.

People struggling to manage their affairs due to medical issues are often unsure of whether applying for SSDI is worth their time. Does the SSA require certain diagnoses for applicants to qualify for benefits?

It would be impossible to list all debilitating conditions

The SSA has disability standards that workers interpret on a case-by-case basis to determine whether someone is eligible for SSDI benefits. Typically, a condition must be so debilitating that it prevents someone from maintaining any gainful employment. Additionally, the person applying needs to have a condition that should last for a year or longer to be eligible for SSDI benefits.

There is a relatively exhaustive list of potentially debilitating medical conditions. The SSA provides lists of conditions that affect different parts of the body, ranging from musculoskeletal disorders to mental health issues. However, simply having a diagnosis of a condition on the list of qualifying impairments does not automatically mean someone is eligible for SSDI benefits. Some people have more severe or less serious cases of debilitating diseases than others. Applicants typically need robust medical evidence exploring how their conditions affect their health and function.

People can potentially qualify for SSDI benefits with conditions that are not on the list of acknowledged disabling disorders. Rare and unusual conditions that present debilitating symptoms can be enough for people to qualify when they have sufficient medical evidence. Reviewing medical records and talking about SSDI benefit requirements with a skilled legal team can help people determine whether they are in a position to apply for benefits. Those with conditions that prevent them from working can theoretically obtain benefits that can help them replace some of their lost income when health challenges force them to leave their jobs.