Social Security Disability – Decisive Factors

by | Published on May 29, 2014 | Social Security Disability

Disabled persons who are under age 65 are eligible to receive SDDI (Social Security Disability Insurance) as well as SSI (Social Security Income). A person is considered disabled under Social Security rules if:

  • The person cannot do work that he/she did before and SS decides that the person cannot adjust to other work on account of his/her medical condition (s).
  • The person does work and is unable to earn over Substantial Gainful Activity (SGA), which is estimated at $1070 a month for the year 2014.
  • The person’s disability lasts / is expected to last for at least one year or to result in death.

The disability analyst would look at an applicant’s age, work and educational background and limitations caused by the condition when determining disability. The analyst would perform a detailed medical chart review to evaluate the applicant’s health condition accurately in regards to their disability. The questions that an applicant may have to answer are:

  • Whether the applicant is working. Ideally he/she should not be earning anything substantial during the SSDI application process.
  • Whether the applicant has a medical condition that affects his/her ability to work.
  • Whether the applicant’s condition is found in SS’s Listing of Impairments. If it is listed, the claim is quickly approved. However, the particular condition must be clearly documented in the medical record.

Read the list of impairments.

If the applicant’s condition does not ideally meet one of the specific listings, SS would then consider if the symptoms the applicant has are as severe as one of the listings. Multiple conditions that are causing the disability can be identified in this way. If the applicant’s condition is in the Listing of Impairments, the analyst would approve the claim.

If the applicant’s condition is not listed in the blue book, the analyst would check whether he/she can do the work they did previously. The focus will be on identifying functional problems the applicant may have, giving importance to information provided in the Daily Activities Questionnaire and the Pain and Fatigue Questionnaire the applicant has to complete. Third party testimony letters from family, friends, colleagues and supervisor will be considered for evaluation of disability. If the applicant is able to do the work he/she did previously, the claim would be denied. If not, the next consideration would be if he/she can do any other type of work. In this regard, the analyst would consider whether the applicant can be retrained. Age is a factor that is considered because jobs can be more easily found for younger applicants.

If the applicant can do other types of work, the disability claim would be denied. If not, the claim would be approved. A careful review of medical records by the applicant’s doctor showing evidence in support of the disability claim would help in obtaining approval at the initial application itself. A claim that is not approved the first time can be appealed through Reconsideration or at an Administrative Hearing depending on the next level of appeal in the particular region. It is important to appeal a denial because it will preserve the original filing date and the applicant will not lose any retrospective benefits when he/she is approved. A social security disability lawyer can be of assistance when appealing such claims.

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