This information may help claimants with representation, as well as claimants who are not represented by an attorney or non attorney representative. Understanding how the Social Security Disability criteria works can make the difference between winning or not winning the continuing disability benefits and backpay to which a person is entitled. |
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The Social Security Administration's definition of disability, i.e. "Disabled" A person is entitled to receive Social Security Disability (SSD) benefits when they are no longer able to perform SGA, or substantial gainful activity, as the result of a physical or mental impairment that is expected to last at least 12 months, or possibly result in death. Meeting the definition of disability To satisfy the definition of disability used by Social Security, a person's disability or impairment must meet or equal the level of severity described in the Social Security listing book. This is essentially the manual that describes dozens of conditions, ranging from arthritis and high blood pressure to asthma, heart failure, and depression. Satisfying the criteria quoted in the listing book will guarantee a disability approval. However, it is very difficult to win a disability approval based on meeting the disability criteria in the listing book. Most individuals will qualify for social security benefits another way---basically where their disabling condition is severe enough that they are unable to perform their past work while earning at least a substantial monetary amount each month. Currently the SGA amount is $900.00 before taxes. Additionally, in this process, it must be concluded that the individual is not capable of doing certain "other work". What exactly is other work? Other work that a claimant might possibly do must be related, according to social security regulations, to several factors: a person's age, level of education, and the type of work they did in the past. For example, a person with a 9th grade education who cannot do their past work will never be expected to perform other work that goes beyond their educational limits. And individuals with mental or affective impairments (low IQ or depression or anxiety) will not be expected to perform other work that requires detailed attention and concentration. Also, as a third example, individuals who are physically incapable of doing more than sedentary work will never be expected to perform work that requires medium (lifting 50 lbs on an occasional basis) or even light (lifting 25 lbs on an occasional basis) exertion. Qualifying for Social Security Monthly Benefits & Past Due Benefits To qualify for disability benefits, an individual must have paid Social Security payroll taxes over a certain length of time. An individual who has done this will be considered insured. The time frame for paying into the system varies by age. And if an individual stops working and paying Social Security taxes, they must be able to show that their disability began before their insured status ran out. Applying for Disability Specific criteria for disability approvals are included in the Social Security Listing of Impairments. It is important to note that a claimant's doctor should be familiar with these criteria when submitting statements on a claimant's behalf. Therefore, it is sometimes useful for a claimant to explain to a doctor just how their condition limits their daily activities. Also, it is important to provide a full listing of all impairments, conditions, and symptoms on the application for Disability, as well as a list of all the doctors, hospitals, and clinics involved in a claimant's treatment (along with addresses and phone numbers). Denials It is not uncommon for a claim for SSD to be denied. In fact, it is the norm and appeals are generally required for disability benefits to be established. Many claims, however, are denied because the patient's medical record lacks adequate documentation that fully establishes the severity of the disability. Therefore, it is essential that all information regarding continuing medical treatment be reported to social security disability. Appealing Disability Denials If the application for SSD is denied, do not reapply. This is a common mistake made by applicants for disability benefits. You should never reapply because new applications will simply be denied again. Instead, file an appeal. Or better yet, seek the services of a qualified disability representative who can guide your case through the disability appeals process. It is simply a fact that represented cases have a much higher chance of winning than those that are not represented. Fortunately, today, there are many qualified representatives who are willing to offer free consultations before they are retained. Many of these organizations and firms, particularly the larger and more specialized ones (who do nothing but disability cases, making them very experienced in that area), can be found and contacted online. Disability Advocates Help with Claims Free Case Evaluation |
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SOCIAL SECURITY DISABILITY ATTORNEY, REPRESENTATIVE LAWYER LIST ANSWERS TO YOUR SSD & SSI QUESTIONS PAGE 1 ANSWERS TO YOUR SSD & SSI QUESTIONS PAGE 2 |
