Understanding Social Security Disability for Disabilities from Birth

The Social Security Administration (SSA) provides disability benefits to individuals who have medical conditions that prevent them from working and have lasted, or are expected to last, for at least 12 months. If your disability is congenital (present from birth), you can still apply for SSDI or SSI, depending on your situation.

• SSDI: To qualify for SSDI, you must have worked and paid into the Social Security system for a sufficient number of years. If you have a disability that began at birth, you likely won’t meet this requirement unless you’ve worked in the past and earned enough work credits.
• SSI: If you haven’t worked or do not have enough work history, you may qualify for SSI, which is a needs-based program for individuals with disabilities who have limited income and resources. SSI is available regardless of your work history, making it a viable option for many individuals with disabilities from birth.

Steps to Apply for Social Security Disability with a Disability from Birth

Step 1: Determine Which Program You Qualify For: SSDI or SSI

• If you are an adult with a disability that began at birth, SSDI may not be available unless you have worked and earned enough work credits. However, if you haven’t worked, SSI may be the more appropriate program.
• For children with disabilities from birth, SSI is often the program that applies, as it focuses on financial need rather than work history.

Step 2: Understand the SSA’s Definition of Disability

The SSA defines disability as a condition that significantly limits your ability to perform basic work tasks, and it must be expected to last for at least 12 months or result in death. In your case, having a disability from birth means the SSA will evaluate how the condition affects your ability to engage in gainful work activities.

• The SSA has a Listing of Impairments that details specific conditions that are considered disabling. Some congenital conditions may be listed, and if your condition meets these criteria, you could qualify for benefits.
• For disabilities from birth, you’ll need to demonstrate how your condition prevents you from engaging in substantial gainful activity (SGA) and how it has affected your functioning over time.

Step 3: Provide Medical Documentation of Your Disability

As with any disability claim, providing detailed and accurate medical documentation is essential. For a disability from birth, you will need to include:

• Medical Records: Your medical records from childhood to the present that show the diagnosis and ongoing treatment for your condition.
• Doctor’s Opinions: A letter or statement from your treating physician explaining how your disability limits your ability to work and function on a daily basis.
• Other Specialists: Include records from any specialists you’ve seen, such as pediatricians, neurologists, or orthopedic surgeons, depending on the nature of your disability.

Step 4: Complete the Application Accurately

Whether applying for SSDI or SSI, it’s crucial that your application is accurate and thorough. The SSA has a detailed application process, and any mistakes or omissions can delay your claim or result in a denial. Here’s how to apply:

• Apply Online: The easiest way to apply for Social Security Disability is through the SSA’s online portal at www.ssa.gov.
• Be Honest and Detailed: Ensure you are as detailed as possible when explaining the impact of your disability on your daily life and ability to work.
• Include All Required Documents: Submit your medical records, physician statements, and any other necessary documents as part of your application.

Step 5: Follow the SSA’s Evaluation Process

The SSA evaluates disability claims based on a five-step process. This process involves determining whether you are working, if your condition is severe, if your condition meets SSA’s impairment listings, and whether you can perform other types of work.

• Step 1: If you are earning above the SSA’s substantial gainful activity (SGA) threshold, your claim may be denied.
• Step 2: Your disability must be severe enough to limit your ability to perform basic work tasks.
• Step 3: If your condition is listed in the SSA’s Listing of Impairments, you may be approved for benefits.
• Step 4 and 5: The SSA will evaluate whether you can perform your past work or any other work based on your skills and age.