How to Win an SSDI or SSI Disability Claim

In order to win your claim for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), you must establish that you have a medically determinable condition that keeps you from working full-time for at least one year. More specifically, you'll have to show that you either meet the requirements of a listed impairment or have functional limitations that rule out not only your past work but also any other jobs in the national economy.

As you may imagine, this isn't an easy task. Just about 39% of disability claims are initially approved, while even fewer (around 15%) are approved after their first appeal. Most people who are eventually awarded disability benefits win only after they've had a hearing with an administrative law judge. Here's what it takes to build the kind of Social Security disability case that can increase your chances of getting approved, whether you win initially or on appeal.

Do My Chances of Winning Disability Go Up With a Lawyer?

Yes. Hiring a lawyer to help with your disability case is worth it, as shown by survey results of our readers who were almost twice as likely to win at the hearing level with an attorney as those without representation. Government statistics support these numbers, with one report finding that disability claimants who had representatives won their cases almost three times as often as claimants who didn't have help.

How Do You Make a Disability Claim?

You make a disability claim by submitting an application for the type of benefit (SSDI or SSI) you're trying to get. Filing the application itself is a simple process. You can begin online using Social Security's web portal, call 800-772-1213 (TTY 800-325-0078) weekdays from 8 a.m. to 7 p.m. to speak with a representative or go in person to your local Social Security field office.

Although you can make your disability claim at any time—including right after you first became disabled—keep in mind that Social Security must expect that your disability will last at least 12 months or your claim will be denied. So if your disability started over nine months ago, you're more likely to get approved for benefits (since it takes about three months to get an initial decision).

Once you apply, a claims examiner with your state's Disability Determination Services will review your file and make an initial decision about whether you meet Social Security's medical definition of disability. If you're denied benefits and appeal the denial, a different claims examiner will reconsider the initial decision and—ideally—award you SSDI or SSI. But it's more likely that you'll have to appeal again and ask for a hearing with a disability judge.

How to Win Your SSI or SSDI Appeal

Several factors make up a winning disability case. First and foremost, you must be able to demonstrate that you have a medical condition that makes you unable to work. You'll need a medical diagnosis of a recognized condition from a qualified doctor or psychologist—preferably a specialist—who can explain how your symptoms make you unable to work.

Get Your Medical Records Together

The disability cases that win are the ones that are better documented—meaning they have recent and detailed medical records that prove a serious medical condition using accepted tests and diagnostic techniques. For instance, if you have cancer, Social Security will want to see evidence such as biopsies showing how far the cancer has spread. Additionally, the agency will review any treatment you've had (like chemotherapy, surgery, or radiation therapy) to see how the side effects have limited your ability to function.

Social Security specifically looks for objective evidence that can be documented on physical examination or through medical imaging or lab tests. The exact type of evidence you'll need depends on the condition you're being treated for. Examples of solid evidence include:

• a straight-leg raising test (for back problems)
• an exercise stress test (for heart problems)
• prescription for a walker, cane, or wheelchair
• X-rays, MRIs, or CT scans, and
• cognitive, memory, or intelligence tests (for mental health problems).

It's harder to win your case if you haven't been to a doctor recently. For many conditions, Social Security will require medical records from the last six months, and sometimes the last three or four months. Make sure you provide the agency with any new medical records for treatment you've received between your initial application and when you file your appeal.

Ask For Your Doctor's Support

It's extremely helpful to your disability case if your doctor supports your claim. If your doctor has been treating you for a long time or is a specialist in the field of medicine covering your impairment—like an oncologist treating a cancer patient—the doctor's opinion will carry more weight. And Social Security will take the opinion of your doctor more seriously if that opinion is backed up by medical evidence.

Having a doctor write a letter for you describing your limitations is probably the single most important document you have at your disposal to win your disability case. Consider asking your doctor for their written opinion and submitting it to Social Security along with your appeal paperwork. You can give your doctor a blank form to fill out with pre-printed questions about your limitations if that's easier.

Document Any Hospitalizations

Hospital admission and discharge records can strengthen your disability case if you can show you have a history of frequent trips to the hospital for conditions such as seizures, heart trouble, COPD, asthma, complications from diabetes, or mental health issues like bipolar disorder.

Be sure to include records of hospitalizations for any procedures or surgeries you had to treat your disabling condition. The more often you had to spend time in the hospital and the longer your hospitalizations lasted, the more likely you are to win your disability case.

Attend a Consultative Exam

You may be asked to go to a consultative examination (on Social Security's dime) if you haven't seen a doctor in more than six months or the agency wants you to have a medical test you haven't had recently. Be sure to attend your consultative exam—if you don't go, Social Security can deny your claim. You can call to reschedule your appointment if the date and time don't work for you.

Consultative exams aren't as helpful to your claim as your regular doctor's observations and opinions are, but if the examiner's findings are supported by your medical record as a whole, the report can help you win your disability case.

How to Win a Social Security Disability Hearing

Once you get to the hearing level, you'll be scheduled to appear—in-person or virtually—before an administrative law judge (ALJ) who will decide your disability case. ALJs use the same criteria for disability that claims examiners do when they review your case at the initial and reconsideration levels, but at this stage they have the opportunity to question you directly about your claim. Therefore, it can be helpful to become familiar with the legal criteria for disability so you can answer the ALJ's questions in a way that strengthens your claim.

Is Your Medical Condition a Listed Impairment?

Social Security's listing of impairments (called the Blue Book) sets out over 200 medical conditions and illnesses that may automatically qualify you for disability benefits. If you meet the specific requirements in an impairment listing, the determination process ends—your SSDI or SSI disability case is approved on the spot. But not every serious impairment is listed in the Blue Book, and the listing criteria can be tough to meet.

Social Security data from 2022 (the most recent available) shows that 46% of SSDI applicants and 53% of SSI applicants who were approved for benefits met the requirements of a listed impairment. But you can still win your disability case even if your medical condition isn't in the Blue Book or doesn't exactly match the requirements of a listing.

Does Your Condition Equal a Listing?

If you have a Blue Book listed impairment but the evidence doesn't meet the listing criteria, or your condition is similar to a listing but not exactly the same, you may win your disability case by "equaling a listing." You can equal a listing if you have a condition (or combination of conditions) that is medically equivalent to a listed impairment.

To win a disability case by equaling a listing, you'll need to show Social Security that your condition is similar in both duration and severity to a listed impairment. It's not an easy thing to do on your own—less than 5% of approvals are based on equaling a listing. Because the listings are often technical and hard to decipher if you're not a medical professional, getting a written statement from your doctor is key here. Or, you (or your lawyer) could request that a medical expert testify at your hearing.

Can You Win Your Case If Your Condition Doesn't Meet or Equal a Listing?

Yes—in fact, most people who win their case do so because they're able to show that they have a residual functional capacity (RFC) that rules out all full-time jobs. Your RFC is a set of limitations that reflect the most you're able to do, physically and mentally, in a work environment. At your hearing, the judge will look at your medical record, doctor's opinions, and daily activities to determine what limitations should be included in your RFC.

Most RFCs contain both "exertional restrictions" on strength-related activities (such as walking and lifting objects) and "non-exertional restrictions," which include all other types of physical movements, environmental limitations, and mental abilities. The more limitations you have in your RFC, the less likely you'll be able to do any job, so you'll want to make sure that Social Security is aware of every work-related limitation that has a basis in your medical record.

Before you attend your hearing, think about how well you'd perform the following activities in a typical eight-hour workday:

• sitting in one place
• standing and walking
• lifting and carrying items weighing 10, 20, or 50 pounds
• using your hands and fingers to move small objects, press buttons, or type
• reach overhead, in front, or to the sides
• bend over, stoop, or crouch down
• climb a ladder or stairs
• tolerate exposure to dust, fumes, or extreme temperatures
• focus on simple tasks without interruption
• follow instructions without making a mistake
• respond appropriately to normal work stress, and
• interact with your coworkers, supervisors, and the general public.

You should be able to answer a judge's questions about how long you'd be able to perform these activities. For example, if you have a painful back condition, your doctor might say that you shouldn't stand or walk for more than two hours in a workday—which would limit you to sedentary jobs. If the judge then asks whether you have any medication side effects that would keep you from working at a desk, and you describe persistent drowsiness that makes you fall asleep at work, the judge could decide that you can't do any sit-down jobs and award you disability benefits.

What Factors Win Social Security Disability Cases?

Age, education, and your work history are additional factors that come into play when determining whether you'll be approved for disability benefits. Disability applicants over the age of 50 typically have an easier time qualifying for benefits using special guidelines called the medical-vocational grid rules to determine whether they can be expected to shift to another line of work if they can no longer do their past jobs.

For example, if you can physically perform sedentary work but you're over 55, didn't graduate high school, and have only done heavy labor (like a longshoreman or miner), Social Security will likely find that any skills you've learned at those jobs won't help you learn how to do a sit-down job—in other words, the skills aren't transferable. Using the grid rules, the agency will find you disabled even though you could do sedentary work under the theory that you're too close to full retirement age to be reasonably expected to change careers.

But if you're 45 years old, have a college education, and previously worked history as a computer programmer, a sedentary RFC won't be enough to qualify for disability benefits. You'll have to show that you can't do even the simplest, least physically demanding jobs, like small parts assembler. One of the most common ways younger claimants can do this is with evidence of limitations that cause reduced productivity—whether from trouble concentrating or excessive absenteeism—outside of customary employer tolerances.

Survey Results: What Are the Chances of Getting Approved for Disability?

Martindale-Nolo surveyed readers who had won and lost their disability cases and analyzed the factors that contributed to the outcome. The results supported the idea that going to the doctor was key to winning disability. The survey also found other factors that indicated better odds of winning an SSDI or SSI case, including quitting work before applying for disability benefits and hiring a disability lawyer before your appeal hearing.

The survey also analyzed how age, gender, and type of benefit (SSDI or SSI) affected the success of a disability case. Learn more about what the survey statistics indicate are the types of cases most likely to be approved for disability benefits.

Getting a Lawyer to Help With Your Disability Claim

The disability determination process can feel overwhelming at times, especially when you're financially struggling while waiting for a decision. Hiring an experienced attorney can help ease some of the frustration, and because disability lawyers work on contingency—meaning they only get paid if you win your case—you should have little, if any, up-front expenses.

Your attorney can help you appeal a denial, communicate with Social Security on your behalf, and represent you at a disability hearing. Most lawyers offer free consultations, so you can ask around to find one who's a good fit. For more information, see our article on how to find a disability lawyer near you.