The legal definition of “disability” states that a person can be considered disabled if they are unable to perform any substantial gainful activity due to a medical or physical impairment or impairments which can be expected to result in death or which has lasted or can be expected to last for a continuous period of ...
You Earn Too Much Income For SSDI, which is the benefit program for workers who have paid into the Social Security system over multiple years, one of the most basic reasons you could be denied benefits is that, when you apply, you are working above the limit where it is considered "substantial gainful activity" (SGA).
We consider your medical conditions, age, education, past work experience, and any transferable skills you may have. If you can't do other work, we'll decide you qualify for disability benefits. If you can do other work, we'll decide that you don't have a qualifying disability and your claim will be denied.
1. Arthritis. Arthritis and other musculoskeletal disabilities are the most commonly approved conditions for disability benefits. If you are unable to walk due to arthritis, or unable to perform dexterous movements like typing or writing, you will qualify.
Making Statements That Can Hurt Your Claim – Unless you are specifically asked pertinent questions, do not talk about alcohol or drug use, criminal history, family members getting disability or unemployment, or similar topics. However, if you are asked directly about any of those topics, answer them truthfully.
A disability is any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities (activity limitation) and interact with the world around them (participation restrictions).
But unfortunately, obtaining SSDI benefits is not easy. In fact, it's rather difficult. Approximately 70% of initial SSDI claims are denied every year. In other words, less than one-third of initial claims are approved.
To calculate how much you would receive as your disability benefit, SSA uses the average amount you've earned per month over a period of your adult years, adjusted for inflation. To simplify this formula here, just enter your typical annual income. This income will be adjusted to estimate wage growth over your career.
If you want to keep yours, here are some tips on how to pass a continuing disability review:Follow Your Treatment Protocol. ... Learn More About Your Condition. ... Answer the Short Form Honestly. ... Keep Copies of Your Medical Records. ... Inform the SSA of Any Change in Address.
OklahomaOklahoma is the hardest state to get for Social Security disability. This state has an SSDI approval rate of only 33.4% in 2020 and also had the worst approval rate in 2019 with 34.6% of SSDI applications approved. Alaska had the second-worst approval rate, with 35.3% of applications approved in 2020 and 36.2% in 2019.
The four most common types of hidden disabilities are:Autoimmune Diseases. In most people, the body's immune system protects them from invaders like bacteria and viruses. ... Mental Health Conditions. ... Neurological Disorders. ... Chronic Pain and Fatigue Disorders.
Top 5 Disabling Conditions that Receive Disability Benefits1) Arthritis. Over 50 million adults and 300,000 children are documented to have some form of arthritis. ... 2) Degenerative Disc Disease. ... 3) Cancer. ... 4) Paralysis. ... 5) Parkinson's Disease. ... Contacting a Social Security Attorney.
When you first contact an attorney for representation, either the attorney or a firm staff member will conduct an initial interview with you to gat...
Your attorney, or a staff member in the law firm, will request the medical records needed to win your claim and submit them to the Social Security...
It is not unusual for attorneys to wait until a month or two before a disability hearing to first speak to a client. Up to that point, your only co...
The SSA allows you to bring a witness to testify about your disability, but because witnesses can be harmful or helpful, your attorney will decide...
Your disability lawyer will determine the best way to win your case. First, your lawyer will review your denial letter from Social Security to get...
There are three main possible "theories" an attorney can use to do this. Your lawyer can: prove that your condition meets a disability "listing". prove that you "grid" out of all work (including not being able to do your past work) prove that your non-exertional limitations prevent you from working, or.
First, your lawyer will review your denial letter from Social Security to get the agency's reasons it denied your claim so that these issues can be resolved in your favor. (For more information, see our article on denial notices .)
At the disability hearing, your lawyer will ask you ask you a series of questions called "hypotheticals." These hypotheticals are designed to rule out the possibility that you can work any type of job due to the limitations imposed by your condition. For more information, see our article on how an attorney uses hypotheticals at a disability hearing. (Also, you may want to learn more in general about what to expect at your disability hearing .)
It is not unusual for attorneys to wait until a month before a disability hearing to first speak to a client. Up to that point, your only contact with the law firm may be with paralegals or staff members. Nonattorney staff members are generally responsible for making sure request for hearing deadlines are met and medical records are requested and received, and for communication with clients about pre-hearing matters.
If your attorney thinks additional testing is needed to meet the listing, he or she may request that an SSA doctor examine you or that you schedule the necessary tests with your physician. If your condition does not seem likely to meet the listing, the attorney will look to other possible theories.
To prove you are not capable of sedentary work, your attorney will use the documented symptoms of your illness, the opinions of your treating doctors, your testimony, and any other objective medical evidence in your file to show why you can't do various sit-down jobs. For example, if your doctor has said that you can't lift more than 10 pounds or sit more than two hours per day, this will help prove that you are capable of "less than sedentary work," meaning that Social Security will have to find you disabled. (For more information, see our article on "less than sedentary" status.
Because Social Security frequently dictates the type of exam needed to win a claim for disability, a legal professional will review your medical records to determine whether you need to undergo additional testing. The legal professional may ask the SSA to schedule a consultative examination (CE) with one of their doctors or ask that you get the required testing done on your own, if need be.
Most SSD benefits applications are rejected for technical reasons that have nothing to do with your disability status.
The majority of social security disability benefits applications are denied at the initial application phase. Many of those denials have nothing to do with whether the applicant is disabled or has sufficient work creds.
If the SSA denies your disability benefits application, you have the option to file an appeal. There are four levels of appeal:
Your local Social Security office can provide a list of legal referral services and nonprofit groups, such as bar associations and legal aid organizations, that can either provide or help you find representation. The National Organization of Social Security Claimants’ Representatives also has a referral service, and you can search online legal directories such as Avvo, FindLaw and Lawyers.com for attorneys in your area who specialize in disability claims.
Having an attorney or advocate can be especially important if you disagree with Social Security's initial decision on your claim and file an appeal.
In a typical fee agreement, the representative's payment is capped by federal law at 25 percent of back pay or $6,000, whichever is less.
Once you've chosen someone to handle your case, you need to notify Social Security in writing. Download an SSA-1696 form from the Social Security website and send the completed version to your local Social Security office. Alternatively, your representative can file it for you electronically. Both you and your representative will need to provide an electronic signature for verification.
A lawyer or advocate can fill out the SSDI or SSI application on your behalf and help gather medical records and other evidence for your claim. They can review your application for mistakes or omissions that could hurt your chances of success and can join you for meetings or conferences with Social Security officials.
Most disability lawyers and advocates work on a contingency basis, meaning they only get paid if your claim is approved. Any fee agreement between you and your representative must be authorized by Social Security.
During the COVID-19 pandemic, Social Security is also permitting claimants to verbally appoint a representative during a telephone hearing with an administrative law judge. You must still submit the written notice afterward.
During the course of representation, a disability attorney or nonlawyer advocate usually has to request a claimant's medical, school, work records, and occasionally medical or psychological examinations; these can be expensive.
Again, the maximum the disability attorney or nonattorney advocate can charge is 25% of your backpay for his or her services, up to a maximum of $6,000. For example, if your back-dated benefits are calculated to be $10,000, your representative will be paid $2,500 and you will receive $7,500. However, an experienced representative is likely to be able to get you more in backpay by negotiating your disability onset date with the SSA —s omething you can't do without a hearing (in an "on-the-record" ALJ decision) if you're not represented.
The representative will be paid only out of your past-due benefits, or "backpay." If no back-dated benefits are awarded, the representative will not receive a fee. However, in this situation and a few others, the representative is allowed to submit a fee petition to Social Security to request a higher fee.
It doesn't usually cost you anything to hire a representative; the fee will be paid out of the disability award you eventually receive. Some representatives, however, will ask you to pay a nominal amount for costs (see below) at the beginning of your case.
Sometimes a representative will ask for money in advance to pay for these items. This is permitted so long as the representative holds the money in trust until it is needed. However, attorneys usually front these costs for their clients. Then, once the case has closed, regardless of whether you win or lose, the attorney will send the client a bill requesting reimbursement for any funds fronted on behalf of the client.
Social Security Disability attorneys and advocates work "on contingency," meaning they get paid only if you win your case. Unlike many attorneys, disability lawyers do not charge up-front fees or require a retainer to work on a Social Security disability case. Most disability attorneys and nonlawyer representatives will be paid a fee only ...
The Social Security Administration (SSA) relies on doctor's records and medical evidence to determine whether you are disabled. Although the SSA will request records from the list of providers you have given them, it is your responsibility to ensure that the agency has received all of your pertinent medical records, ...
A claimant who files for disability based on type 2 diabetes, chronic obstructive pulmonary disease (COPD), and depression needs to provide the following types of information in support of her claim: a detailed description of the claimant's medications and documented side effects.
Here are some things that a mental RFC should discuss: your ability to understand, remember, and carry out simple instructions. your ability to interact with co-workers. your ability to react to criticism or authority figures. your ability to interact with the general public. your memory.
The SSA outlines a number of conditions that, if all the criteria are met, are eligible for automatic approval. These conditions are known as "listings." If your doctor thinks that your condition qualifies for automatic approval under a listing, the doctor should complete a listing form that explains his or her opinion and provide the appropriate medical documentation. Here is an example.
Remember, though, that RFCs must be supported by objective medical evidence for the SSA to give them consideration; otherwise the SSA can disregard them.
You need to provide medical records only from the doctors who have treated you for your disabling condition. If you have multiple disabilities, you will need to provide the SSA with medical records from all of the different doctors who have treated you. Make sure that you don't provide the SSA with irrelevant medical records.
The claimant was diagnosed with skin cancer, specifically sarcoma. Sarcoma of the skin is eligible for automatic approval for benefits under the disability listing for cancers if the cancer has spread (metastasized) to, or beyond, the regional lymph nodes. A biopsy revealed that the claimant's cancer had spread. To prove she met the listing requirements for sarcoma of the skin, the claimant provided the following information from her doctor.
A disability lawyer can take over getting necessary medical records and doctors' opinions and can manage the hearing process for the applicant.
The medical-vocational allowance allows those who suffer from a schizophrenic condition that doesn't meet the requirements of the listing to get benefits if they can prove that their impairment is severe and ongoing (expected to last for a period of not less than twelve months) and that it prevents the person from doing even unskilled work. It often takes a qualified disability attorney to make this argument, particularly when it comes to appearing before an administrative law judge (ALJ) at a disability hearing.
The disability criteria for schizophrenia are a reflection of the complexity of the medical condition itself. There are no biological tests that can be conducted to establish schizophrenia, but brain imaging shows distinctive changes and may soon be accurate enough to use. For now, diagnosis is still currently by mental status examination.
Although treatment responses vary, it is impossible for even the best treatment to restore a person with schizophrenia to complete normality.
Disability applicants who have complex mental conditions like schizophrenia or other psychotic disorders should consider hiring an experienced disability attorney to represent them . Not only is schizophrenia a complicated disorder, but those who suffer from it are at a great disadvantage when they choose to represent themselves, particularly in light of the limitations this condition places on concentration, memory, and logical thinking. A disability lawyer can take over getting necessary medical records and doctors' opinions and can manage the hearing process for the applicant.
Those who have schizophrenia or another psychotic disorder but are unable to meet the criteria of Social Security's listing may still be able to get SSDI/SSI benefits on the basis of a "medical-vocational allowance." There are applicants who suffer from schizophrenia who are not incoherent or completely disassociated from reality, but they still find themselves unable to hold down a job. While many people who are schizophrenic exhibit stereotypical symptoms such as hearing voices, thinking everyone is out to get them (paranoia), or catatonia, there are also those who are simply unable to make normal associations, participate in normal social interaction, and maintain an organized thought pattern.
First, some background on the procedure of applying for SSI or SSDI: After you submit an application, the Social Security Administration (SSA) will start out by deciding whether you meet the financial and/or work-history requirements. If you don't, you'll receive a nonmedical, or "technical," denial. If you advance to the next stage, a disability examiner will then put your application through a five-step medical evaluation. (For more details, see our articles on technical disability denials and the SSDI/SSI determination process .)
Even if you're earning under the allowed amount, it can be much harder to prove that you're disabled if you're doing any work . But Social Security's claims examiners and judges also appreciate a long employment history, so being out of work for a long time might be a problem as well.
This isn't surprising, since applicants who are working over the limit that Social Security allows are instantly denied. Even if you're earning under the allowed amount, it can be much harder to prove that you're disabled if you're doing any work.
As anyone who's been through the process will tell you, it isn't easy to get Social Security disability benefits. Our survey backed up that general impression. Overall, only about four in ten (42%) of our readers were ultimately approved for benefits.
Clearly, you should see a doctor or other medical professional in order to create that evidence. One-third of our readers said they had not seen a doctor or other medical professional in the year before they applied for disability.
Finally, our female readers were somewhat more likely than the men to have applied for SSI—14% of women, compared to 11% of men. (Women are less likely than men to be insured for SSDI; almost 80% of men are insured for SSDI while only about 70% of women are insured, meaning they're more likely to have to apply for SSI.) As we've seen, SSI applications have lower approval rates than SSDI.