Social Security Disability, also known as Social Security Disability Insurance (SSDI), is an important program that helps millions of people in the U.S. each year. Designed to support those who can no longer work due to severe health issues, it’s a lifeline that can lift injured or afflicted people from poverty and struggle. However, many people who are seeking it wonder, what kind of disabilities aren’t covered under Social Security disability?
This federal program maintains strict eligibility requirements for determining who is and isn’t eligible. Even if a person struggles to work due to health issues, they may not qualify for benefits if their condition falls outside the determining metrics. For those unsure whether they qualify or will in the future, hiring a Social Security Disability attorney can be helpful.
Understanding Social Security Disability’s Eligibility Requirements
The Social Security Administration (SSA) doesn’t approve or reject benefit applications based on a diagnosis. Instead, officials determine eligibility based on whether the diagnosis meets the program’s strict eligibility criteria. To understand what doesn’t qualify, it helps to know what does. To qualify, a person’s condition must be:
- Medically determinable through official reports
- Severe enough to limit basic work activities
- Expected to last 12 months or more, or cause death
Disability is determined by whether a person can engage in Substantial Gainful Activity (SGA). This is defined as work, including part-time arrangements, for the purpose of generating or with the intent of generating pay or profit.
What Conditions Don’t Qualify and Why?
Social Security Disability laws are written to create limitations on the program’s access. Since it’s designed to function as a long-term resource for those with legitimate, debilitating conditions, many common ailments, even if painful or serious, do not apply. These can include:
- Short-term conditions. A broken bone, a temporary skin condition, and post-surgical soreness are all examples of situations that are expected to heal eventually. If they fail to limit SGA for 12 months or more, they won’t meet the criteria for benefits.
- Mild or reasonably controllable conditions. Symptoms must be deemed serious enough to limit long-term work to qualify. Even conditions that cause discomfort in work environments, such as sensitivity to light or sound, may not meet eligibility requirements if they are mild, temporary, or reasonably treatable.
- Conditions without medical evidence. Some people maintain they suffer from unidentified symptoms. However, a successful Social Security Disability case requires clinical findings.
- Intermittent conditions. Even if a person experiences medically documented issues like chronic migraines, digestive issues, or breathing problems, these issues may fail to meet eligibility requirements if they’re intermittent and don’t affect long-term SGA.
- Substance-induced conditions: If a person faces medical issues due to self-induced substance problems from alcohol or other drugs, they may not qualify for benefits. Whether substances are a material contributing factor will be determined in accordance with Section 416.935 of the Code of Federal Regulations.
Since medical conditions can be unique, prone to change, and sometimes hard to document, proving eligibility can be a challenge. A skilled lawyer can help you determine your chances of qualifying and assist you in building a professional case.
How Social Security Disability Could Impact Your Future
The SSA notes that a 20-year-old worker has a 1-in-4 chance of developing a disability before retirement age. A debilitating condition can develop at any point in life and strike without warning, leaving people dependent on this crucial program to maintain their standard of living. There were nearly 7.2 million individuals receiving disability payments in late 2025, underscoring the program’s breadth and impact on those who depend on it.
When you hire a Social Security Disability lawyer from a respected firm, they can help increase the chance of a successful application. Your Sacramento or Stockton Social Security disability case will likely be handled first by the SSA’s Sacramento Office and potentially be referred to the U.S. District Court for the Eastern District of California if appeals are exhausted.
FAQs
Q: How Long Does an Application for Disability Take?
A: The timeline for an application for disability can vary in length, depending on a variety of factors. Some people may have a harder time proving their disability than others, which can extend their Social Security Disability case with additional reviews and appeals. Even after approval, the timeline for receiving your benefits can vary due to administrative delays and backlogs.
Q: Can a Person’s Family Receive Their Benefits?
A: Yes, it is possible for an individual’s family to receive their benefits. In April 2024, payments were made to 86,000 spouses and to over 1.1 million children under 18. This essential aspect of the program makes it influential not just for workers but also for those who depend on them economically.
Q: How Can a Social Security Disability Attorney Help You?
A: A Social Security Disability attorney can help you in multiple ways. Your legal counsel can provide detailed information about the qualifying criteria to help you understand your chances of approval. They can also help you gather evidence, such as medical reports and official statements, to increase your chances of receiving the benefits you need.
Q: Where Could I Get Medical Reports for a Disability?
A: You can get medical reports detailing the condition you believe has impacted your ability to work from a local Sacramento medical facility, such as UC Davis Health. Since the SSA requires medical documentation to consider a disability claim, this is an essential part of the process for assessing your condition clinically and building your case.
Hire a Social Security Disability Lawyer
At Gade & Parekh, LLP, we understand how crucial it is for those in need to receive Social Security Disability approval. In some cases, this can be a matter of health, safety, and dignity, as these essential benefits could spell the difference between a respectable standard of living and a state of poverty and marginalization.
We have a history of serving the great people of Sacramento and the surrounding areas, and our commitment to positive results has made us a go-to choice for those who need benefits. We don’t get paid unless you receive the benefits you seek, which demonstrates our commitment to you and our confidence in our team. Reach out to speak with a Stockton Social Security Disability lawyer today and start with a free consultation.