What is the Social Security Disability 5 Year Rule?

What is the Social Security Disability 5 Year Rule?

Living with a disability can be a horrifying experience. It may leave you physically weak and mentally traumatized. If disability renders you unable to work, it may even mount financial problems and make it difficult for you to meet everyday expenses. In such a situation, benefits through the Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) programs administered by the Social Security Administration (SSA) may offer some much-needed relief.

However, qualifying for SSI or SSDI benefits is extremely difficult due to a maze of complicated procedures and technicalities set up by the SSA. At Clauson Law, an experienced and accomplished Social Security Disability (SSD) benefits lawyer can help you understand the eligibility criteria details of the SSDI and SSI benefits programs, and whether your case meets the qualification benchmark.

Having a broad idea about the qualification criteria for SSD benefits can help you decide whether you can apply for the disability benefits that you need and whether your work history is long enough for you to qualify for SSDI benefits. SSDI benefits are however based on work credits and the 5-year rule, understanding which may help you assess where you understand and whether you can win SSDI benefits.                                           

What is SSDI?

The SSDI is a federal insurance program managed by the SSA. The taxes that you pay into the Social Security system through income earned at a job or through self-employment goes towards your eligibility to receive SSDI benefits from the Social Security Administration.

The SSDI program is intended to provide monthly benefits to those who are unable to work because of a medically determinable physical and/ or mental impairment(s) that have lasted for at least 12 months or are expected to last for a minimum of 12 months or result in death. At Clauson Law, an accomplished SSDI benefits lawyer to help you navigate through the complicated SSDI application process and tight federal regulations set up by the SSA.

Qualification Criteria for SSDI Benefits

To meet the criteria for winning Social Security Disability Insurance benefits, you must establish that you meet the following three conditions:

• You are disabled, that is, you must meet one or more of the medical conditions that match the Social Security Administration’s definition of disability.
• You are unable to work for one year because of your disability.
• You must have worked long enough and paid sufficient Social Security taxes to qualify for SSDI benefits according to the standards set by the SSA.

The amount you can receive as monthly SSDI benefits depends on several factors, including your earnings record. They are calculated based on your lifetime earnings. The more you earned and paid Social Security taxes on, the more you receive in the form of SSDI benefits. An experienced SSDI benefits lawyer at Clauson Law can go through your earnings record to find out how much you are entitled to receive in monthly benefits from the SSA.

What Is the Social Security Disability 5-Year Rule?

Under SSDI, employees win credits for the income that they earn every year. For every year, employees can earn up to four credits. The amount that you must earn to get one credit changes annually and goes up slightly as the average earnings level increases. As of 2023, you receive 1 credit for each $1,640 of earnings. The credits that you have once earned remain on your earnings record, even if there is a job change or you stop earning for a while.

Most people need a minimum of 40 work credits to qualify for SSDI benefits. The exact number of work credits that are needed depends on the applicant’s age and work history. However, at least 20 of those work credits must have been earned in 10 years immediately preceding your disability. Since you need to work for at least five years to gain 20 work credits, you must have worked for five out of ten years preceding your disability to qualify for SSDI benefits. This can be described as the Social Security Disability 5-year rule.

Younger workers have less stringent work requirements as compared to older workers but if you have not worked within the previous ten years, you are unlikely to qualify for SSDI benefits.

How Do You Earn Work Credits?

You can earn work credits through contributions made to the Social Security fund out of the taxes on your income. The income that you need to earn for getting a work credit depends on the amount fixed by the SSA for that year.

What If You Do Not Have Enough Work Credits?

You cannot qualify for SSDI benefits if you do not have enough work credits or fail to satisfy the Social Security Disability 5-year rule. However, you can still qualify for benefits through the Supplemental Security Income (SSI) program of the Social Security Administration. To qualify for SSI benefits, the applicant must be 65 or older, blind, or disabled.

Contrary to the SSDI, you do not need any prior work history for the SSI. It is not a federal insurance program unlike Social Security Disability Insurance, but a means-tested program administered by the Social Security Administration to help such disabled individuals who do not have sufficient income or resources to meet their everyday expenses.

Moreover, you must also meet the income and resource limitations set by the SSA for SSI benefits, and not receive any other cash benefits or payments.

The resource limitations include bank accounts and other financial accounts, life insurance, land, vehicles, and other private property. It includes anything that can be sold and used to acquire food or shelter. For this purpose, an individual can have resources worth up to $2,000 and a married couple can have resources worth up to $3,000.

However, the numerous regulations and technicalities involved in the process to apply for SSI benefits makes it extremely difficult for individuals to understand if they qualify for the needs-based program. This can make it very tricky for an applicant to navigate through the SSI application process. However, a knowledgeable and experienced SSI benefits lawyer at our office can help you win the benefits you need and deserve.

Additional Qualifications For Winning Disability Benefits

Irrespective of the benefits program that you are applying for, that is, Social Security Disability Insurance or Supplemental Security Income, you must prove that you suffer from a medical condition that meets the SSA’s criteria and meaning of disability, and that it has lasted or is expected to last for at least one year.

Qualifying conditions to meet the SSA criteria are listed in the SSA Listing of Impairments, also known as the “Blue Book”. To qualify for benefits under a particular disability, you must match the criteria listed against that disability in the Blue Book.

While the SSA Blue Book is quite comprehensive and contains most of the disabilities, it is possible that you do not find your symptoms in the Listing of Impairments. However, if your physical and/ or mental impairment (s) do prevent you from working, you may still prove your inability to work based on an assessment of your Residual Functional Capacity (RFC).

The claims examiner uses your medical records and any statements from your doctor or medical health professional to develop your Residual Functional Capacity form. The RFC states the activities you can do and the activities you cannot do because of the limitations caused by your disability.

To ensure that your SSDI benefits application contains an RFC that is detailed, complete and proper, you can ask your doctor to fill out a form detailing the physical and other limitations that you have.

Contact An Experienced and Knowledgeable SSD Benefits Lawyer At Clauson Law

Winning SSI or SSDI benefits is not a simple and straightforward task. A number of complicated federal regulations and application processes like the Social Security Disability 5-year rule make it extremely difficult to win disability benefits even if you do meet the eligibility requirements. More than two-thirds of all applications for SSI and SSDI benefits made to the SSA result in a notice of denial.

However, just because your application for disability benefits is denied at the initial determination stage does not mean that you do not qualify for SSD benefits. Many applicants successfully appeal the denial of their claims and reverse the initial determination at different levels of the appeals process. An accomplished SSI or SSDI benefits lawyer at Clauson Law can help you take on the SSA and fight for the benefits you need and deserve.

If you or a loved one suffers from a disability that prevents you from working, you must consider applying for SSDI or SSI benefits to meet your daily needs and expenses. Depending on your work history, age, and type of disability, you may qualify either for SSI benefits or for SSDI benefits. Speaking with an experienced and knowledgeable SSI or SSDI benefits lawyer at our office may help you assess your condition and apply for SSD benefits accordingly. Contact Clauson Law today for a free consultation and claim review.