There are various types of medical conditions that can qualify you for Social Security disability benefits, from anxiety disorders to cancer. If your condition, be it an illness or an injury, impairs you to the point that you can no longer work for an extended period of time, then you may be able to collect monthly benefits.
However, the Social Security Administration (SSA) has very strict guidelines when it comes to getting approved for disability benefits and there are various criteria you must meet. For help with the application process and collecting the documents you need to support your claim, call the Disability Advantage Group at 865-566-0800 and request a free consultation.
When does the SSA consider someone disabled?
The SSA defines a disability as “the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”
SGA simply means having a monthly income over a certain threshold. In 2017, if your monthly income exceeds $1,170, then you are engaging in SGA, and the SSA will not consider you disabled.
In other words, the SSA will consider you disabled when:
- You have a mental or physical condition that prevents you from doing any substantial type of work; and
- Your condition has lasted, or a doctor expects it to last, at least a year.
Note, the SSA only provides disability benefits for total disabilities. That is, your disability must be essentially totally impairing and prevent you from working. There are no benefits for partial disabilities.
How can I prove I qualify for disability benefits?
There are two ways to meet the SSA’s definition of disability, the first of which is to prove that you have one the conditions listed in the “Blue Book.” The Blue Book is the SSA handbook that sets forth the rules and procedures for identifying and evaluating disabilities that qualify someone for benefits.
The Blue Book is a listing of impairments that qualify as disabling, so long as the claimant meets the severity criteria under the appropriate listing. The SSA divides the qualifying disabilities into 14 categories:
- Musculoskeletal Problems (e.g., back injuries, amputation, femur fractures)
- Special Senses and Speech (e.g., hearing loss, loss of speech, loss of visual efficiency)
- Respiratory System (e.g., chronic pulmonary hypertension, asthma, cystic fibrosis)
- Cardiovascular System (e.g., chronic pulmonary hypertension, heart failure, chronic venous insufficiency)
- Digestive System (e.g., short bowel syndrome, liver disease, irritable bowel syndrome)
- Genitourinary Impairments (e.g., chronic kidney disease, nephrotic syndrome)
- Hematological Disorders (e.g., bone marrow failure, sickle cell disease, hemophilia)
- Skin Disorders (e.g., dermatitis, ichthyosis, burns)
- Endocrine Disorders (e.g., diabetes, hyperglycemia, adrenal gland disorders)
- Congenital Disorders that Affect Multiple Body Systems (e.g., Down syndrome)
- Neurological (e.g., Parkinsonian syndrome, epilepsy, cerebral palsy)
- Mental Disorders (e.g., schizophrenia, bipolar disorder, intellectual disorders)
- Malignant Neoplastic Diseases (e.g., lymphoma, multiple myeloma)
- Immune System Disorders (e.g., lupus, HIV/AIDs, inflammatory arthritis)
Remember that merely having a condition on the listing of impairments is not sufficient to win disability benefits. You must also meet the severity criteria for that listing.
For example, for chronic pulmonary hypertension to be serious enough to be a disability qualification, the Blue Book stipulates that your mean pulmonary artery pressure must be “equal to or greater than 40 mm Hg, as determined by cardiac catheterization while medically stable.”
Meeting medical requirements and proving a disability to the SSA can be tough. Our disability attorneys at Disability Advantage Group can help. Call us at 865-566-0800 to discuss your benefits and how we can help you secure your much needed benefits.
Can I still qualify for benefits if I do not meet the listing criteria?
If your medical condition is not on the list or does not quite meet the severity criteria for a listing, you are not automatically disqualified from benefits. Proving that you have a medical condition that is in the Blue Book is only one way to meet the SSA’s definition of disabled. The other way is to prove that you have a condition that is so severe it keeps you from adjusting to any type of work.
When you submit your application, the claims examiner will evaluate your medical records and analyze your functional capacities. S/he will consider your medical and mental condition(s), your signs and symptoms, the limitations your condition causes, your age, your work history, and your education.
If the SSA finds that, given all of these factors, you cannot go back to your previous job and there is no work you can adjust to, it may still award you benefits.
How do I prove my medical condition to the SSA?
Your medical records will serve as your primary evidence for establishing your disability claim. The SSA will want to see all of your records from all the acceptable medical sources where you received treatment for your impairments and related conditions. This includes records from your regular doctor, specialists, clinics, hospitals, mental health professionals, and any other providers that have treated you.
You will need to submit medical evidence appropriate for your particular condition. For example, if applying for disability for short bowel syndrome, you will need to give the SSA with a copy of the operative report of intestinal resection, details of the surgical findings, and postoperative imaging studies that reflect the amount of your residual small intestine.
Lack of sufficient medical evidence will result in a claim denial. The Disability Advantage Group can help you gather the necessary records and efficiently navigate the disability claims process. Call our office today at 865-566-0800 to get started.