Social Security Disability (SSD) is for disabled persons who have collected enough work credits through their employment history, in which they have paid into Social Security through payroll taxes. SSD benefits will not pay for partial or temporary disability but are instead meant for workers whose disability is totally disabling and is expected to last at least a year.
In addition to having enough work credits, workers have to meet other Social Security Administration (SSA) eligibility requirements. To apply for SSD, a worker must:
- Be age 18 or older;
- Be unable to work because of a medical condition that is expected to last at least 12 months or result in death and
- Have not been denied disability benefits in the last 60 days.
Some medical conditions may qualify for disability benefits if they are listed on the SSA’s impairment manual. A sample of these conditions from the 2017 list are below:
|Listed Conditions||Example Conditions|
|Syndromes||Sjogren’s Syndrome and Marfan Syndrome|
|Immune System Disorders||HIV/AIDS, lupus and rheumatoid arthritis|
|Cardiovascular Disorders||Heart failure or coronary artery disease|
|Respiratory Illnesses||COPD and asthma|
|Mental Disorders||Depression, anxiety, schizophrenia, and autism|
|Digestive Disorders||Liver Disease and Inflammatory Bowel Disease|
|Musculoskeletal Problems||Back and neck injuries|
The manual also provides specific criteria that each condition must meet in order to qualify. However, the SSA will still make considerations for those who do not meet the exact requirements, so long as the worker can prove that the condition interferes with his/her ability to work.
If your condition is not listed, this doesn’t mean you are not eligible, the SSA will still consider other conditions.
How to file for Social Security Disability
While persons who are applying for SSD benefits has been steadily increasing, the approval rate is still very narrow, with only about 36 percent of initial applications being approved. Thus, it’s very important to gather all your evidence and follow deadlines to increase chances of success. Some things to keep in mind before you start the application process:
- Establishing good medical records. An SSD claims examiner who will be reviewing all of your claim, will be looking to see if you’ve received regular care for your condition.
- Proving the severity of your disability. This is a big reason why people get denied, because the SSD examiner doesn’t find the condition to be severe enough. It helps to include a written statement from your doctor about the extent of your disability, as well as using a Residual Functional Capacity Form.
- Meet the income requirements. The SSA has rules that an applicant cannot engage in substantial gainful activity if they wish to receive SSD. As of 2017, SSA considers anything over $1,170 a month to be gainful activity. SSA increases this amount every year, so be sure to check their website on income limits.
|If you would like more information on applying for Social Security Disability, or want answers to Frequently Asked Questions, please download our free legal Guide here.|
New SSA Rules for Disability Claims
Earlier this year the Social Security Administration (SSA) published new rules in the Federal Register (82 FR 5844) regarding the evaluation of medical evidence in disability claims. All Social Security disability claims, including Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) claims, filed on or after March 27, 2017, will be assessed according to these new rules.The following rules have been revised:
- Rules about acceptable medical sources;
- How the SSA considers and articulates their consideration of medical opinions and prior administrative medical findings;
- The SSA’s articulation requirements for other kinds of evidence;
- The rules about medical and psychological consultants; and
- The rules about treating sources.
Previously, when you filed a Social Security disability claim, the Administrative Law Judges and claim reviewers evaluating the medical evidence in your claim could give more weight to the opinions of your treating physician.
Now, evidence from your treating physician will be given the same weight as evidence from a medical consultant hired to conduct a one-time evaluation or to simply review your paperwork. This may make it more difficult to get a claim approved, especially for those suffering from conditions like lupus where symptoms aren’t always obvious.
Additionally, a disability rating from another governmental agency like the VA will no longer be given extra weight, increasingly making it more difficult to get a claim approved. The good news is that claim reviewers can still consider the medical information that led to the previous disability rating when reviewing a SSDI or SSI claim.
Social Security Disability Claim Denial
According to the nonprofit National Organization of Social Security Claimants’ Representatives, only about one-third of initial disability claims are approved. That means over 66 percent of applicants will be denied.
Should you be denied, it’s important to file an appeal before the 60-day deadline. An appeal can be filed online, from the SSA’s website.
If a person receives a denial letter, he or she may file an appeal and request a hearing before an administrative law judge. If that appeal is unsuccessful, the person may appeal the judge’s determination to the Appeals Council. The final opportunity is to file suit in federal court.
How a lawyer can help
Advice tailored to each case. A disability lawyer can advise you on weighing the benefits and risks regarding whether it’s worth applying for continued benefits (in case you have to pay them back). They can help speed up the wait for a hearing by drafting and submitting a Dire Need Letter.
Help avoiding common mistakes. A disability attorney can advise you on what you should be doing, so you don’t fall victim to common mistakes that would hurt your case, such as: not taking medication, continuing to work, or missing various appeal deadlines.
Evidence, evidence, evidence. Additionally, just because your doctor says you are disabled, does not mean the SSA will approve your claim. A disability lawyer is trained and knows what kind of evidence SSA wants in order to approve a claim. They can make sure that the right evidence is collected and presented in a way that will ensure the best possible outcome.
But how can I afford an attorney if I cannot work? Law dictates certain ethical standards for attorneys, one being that they must operate in their client’s best interest. Hence, we will work with you to determine the best fee arrangement for you. Depending on the strength of your case, Robinson & Henry offers either a hourly fee agreement or a contingent fee agreement. According to the American Bar Association, a contingent fee agreement is one in which the client doesn’t pay any fees if the case is lost; if the case is won, then the fee – usually a fixed percentage – will be taken out of the amount won.