Work and Social Security Disability
In order to be approved for disability, you must meet three basic disability criteria: 1) You must prove that you suffer from a medical condition (physical or mental) that is severe enough to keep you from performing work; 2) That your medical condition is expected to last at least 12 months; and, 3) that you are incapable of performing any other work (other than your current job) for which you may be suited.
The first criterion is fairly straightforward, and decided solely on the basis of medical records. There are some instances in which claimants are denied disability benefits despite the fact that they have presented ample medical documentation, because a disability examiner will decide that their impairment, while limiting, is not severe enough to prevent them from working.
However, denials based on NSI (Non-Severe-Impairment) are not as common as you might think, probably because most people don’t put themselves through the grief of the disability determination process unless they are suffering from a condition that is severe. As anyone who has filed a disability claim knows, the process is far from easy, and it can be both frustrating and demoralizing—the majority of people will work until they are no longer able to do so.
Of course, even if you have a medical diagnosis and treatment history to back up your disability claim, you must also be able to prove that your condition is long-term, or ongoing in nature (lasting at least 12 months). Does this mean that you must suffer with a medical condition for a year before you can file for disability benefits? Actually no, because most physicians, even those working for the social security administration, can look at a patient’s medical records and determine if a condition is likely to continue for several months or more. Again, with proper medical documentation from your physician, you should have little trouble meeting the burden of proof in this matter.
However, it gets a bit tricky when it comes to proving that your disability not only prevents you from performing your current job, but also excludes you from any type of other work from which you may earn substantial gainful activity (SGA). (The SGA is a maximum amount set by Social Security that a disability applicant may earn each month. To see the current amount, visit this page - Substantial gainful activity.).
While it may be easy to prove that you are unable to perform your current job due to your medical symptoms, it can be quite difficult to prove that you can’t perform any other type of work, given all of the different professions/activities in which an individual might be employed. When considering “other work,” a disability examiner will include, not only any job which you’ve held within the last 15 years, but also any other job for which you may be qualified (even if that job is not available in your state).
Is it fair to tell someone living in a small town, for example, that they are denied benefits based on an educated guess that they could perform a job that isn’t even available? Of course not, and the SSA does realize this as well. For this reason all disability examiners and administrative judges acting for the social security administration must refer to “the grid,”. This vocational grid includes allowances for a person’s education, age, physical and mental limitations, and past work experience, and thus makes it impossible for a disability examiner or judge to tell an injured construction worker that he or she does not qualify for disability because a career in public relations is still possible (you get the point).
However, the fact that the grid exists doesn’t mean that it is always applied fairly, or even realistically. The majority of disability denials are indeed based on a disability examiner’s decision that the claimant is fit to perform “other work.”
If your disability claim has been denied on the basis that you are still capable of performing work, your best bet is to obtain legal representation and appeal the matter. And, if disability determination services (DDS) turns down your reconsideration appeal, it is absolutely critical that you obtain a good disability attorney or non-attorney rep before you appeal again. The next appeal is before an administrative law judge, and all statistics point to the fact that claimants with representation succeed in winning benefits up to 50 percent more often from ALJs than those who represent themselves.
An experienced disability lawyer or non-attorney rep will have a thorough understanding of the vocational grid, and will know how to put together a persuasive legal argument that explains to a judge exactly how your physical (or mental) limitations and your place on the vocational grid prevent you from performing any other work, which is really the key to winning disability benefits.
Return to:
Social Security Disability Secrets
Social Security Disability Benefits Questions
Additional topics
Filing a reconsideration for SSI
The ALJ social security disability decision
Social Security Total Disability
The first criterion is fairly straightforward, and decided solely on the basis of medical records. There are some instances in which claimants are denied disability benefits despite the fact that they have presented ample medical documentation, because a disability examiner will decide that their impairment, while limiting, is not severe enough to prevent them from working.
However, denials based on NSI (Non-Severe-Impairment) are not as common as you might think, probably because most people don’t put themselves through the grief of the disability determination process unless they are suffering from a condition that is severe. As anyone who has filed a disability claim knows, the process is far from easy, and it can be both frustrating and demoralizing—the majority of people will work until they are no longer able to do so.
Of course, even if you have a medical diagnosis and treatment history to back up your disability claim, you must also be able to prove that your condition is long-term, or ongoing in nature (lasting at least 12 months). Does this mean that you must suffer with a medical condition for a year before you can file for disability benefits? Actually no, because most physicians, even those working for the social security administration, can look at a patient’s medical records and determine if a condition is likely to continue for several months or more. Again, with proper medical documentation from your physician, you should have little trouble meeting the burden of proof in this matter.
However, it gets a bit tricky when it comes to proving that your disability not only prevents you from performing your current job, but also excludes you from any type of other work from which you may earn substantial gainful activity (SGA). (The SGA is a maximum amount set by Social Security that a disability applicant may earn each month. To see the current amount, visit this page - Substantial gainful activity.).
While it may be easy to prove that you are unable to perform your current job due to your medical symptoms, it can be quite difficult to prove that you can’t perform any other type of work, given all of the different professions/activities in which an individual might be employed. When considering “other work,” a disability examiner will include, not only any job which you’ve held within the last 15 years, but also any other job for which you may be qualified (even if that job is not available in your state).
Is it fair to tell someone living in a small town, for example, that they are denied benefits based on an educated guess that they could perform a job that isn’t even available? Of course not, and the SSA does realize this as well. For this reason all disability examiners and administrative judges acting for the social security administration must refer to “the grid,”. This vocational grid includes allowances for a person’s education, age, physical and mental limitations, and past work experience, and thus makes it impossible for a disability examiner or judge to tell an injured construction worker that he or she does not qualify for disability because a career in public relations is still possible (you get the point).
However, the fact that the grid exists doesn’t mean that it is always applied fairly, or even realistically. The majority of disability denials are indeed based on a disability examiner’s decision that the claimant is fit to perform “other work.”
If your disability claim has been denied on the basis that you are still capable of performing work, your best bet is to obtain legal representation and appeal the matter. And, if disability determination services (DDS) turns down your reconsideration appeal, it is absolutely critical that you obtain a good disability attorney or non-attorney rep before you appeal again. The next appeal is before an administrative law judge, and all statistics point to the fact that claimants with representation succeed in winning benefits up to 50 percent more often from ALJs than those who represent themselves.
An experienced disability lawyer or non-attorney rep will have a thorough understanding of the vocational grid, and will know how to put together a persuasive legal argument that explains to a judge exactly how your physical (or mental) limitations and your place on the vocational grid prevent you from performing any other work, which is really the key to winning disability benefits.
Return to:
Additional topics
Filing a reconsideration for SSI
The ALJ social security disability decision
Social Security Total Disability
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