What does the Social Security Disability Insurance program cover?

Since the 1950s, the federal government has provided a safety net to people who are considered disabled, and are unable to work and support themselves and their dependents. The Social Security Disability Insurance and Supplemental Security Income system provides care for people who are terminally ill or disabled to the point that it is unlikely that they will ever be able to work again.

Nearly since its inception, the government has worried about how much money this program will cost. Providing financial support to someone for the rest of their life could get quite expensive, especially considering people are living longer today than ever before. In order to control costs, the Social Security Administration (SSA) has put a rather strict definition of “disabled” in place to limit the number of people who can enroll in the program.

The SSA definition of disability is a complex one. In order to be considered disabled by the Administration:

“you must not be able to engage in any substantial gainful activity (SGA) because of a medically-determinable physical or mental impairment(s):

• That is expected to result in death, or
• That has lasted or is expected to last for a continuous period of at least 12 months.”

The key to determining if you are eligible for disability usually rests not on the disability part of this definition, but on the substantial gainful activity part.

According to the SSA, “Work is ‘substantial’ if it involves doing significant physical or mental activities or a combination of both.” This definition means even part-time, very low wage/low skill work counts.

“’Gainful’ work activity is:

• Work performed for pay or profit; or
• Work of a nature generally performed for pay or profit; or
• Work intended for profit, whether or not a profit is realized.”

The government looks at what you could expect to earn from the amount of “substantial,” “gainful” work you can do, and compares that to earnings guidelines it has developed. If you fall below a certain amount, presumably an amount necessary to support yourself, you qualify.

The earnings guidelines change each year, and it seems like the SAA’s ideas about what “substantial” and “gainful” do as well (even though the letter of the law does not change). So working with an attorney who has experience dealing with the SSA is advised.