No illnesses, injuries, or other medical conditions will automatically qualify you for Social Security Disability Insurance (or SSDI) benefits. However, the Social Security Administration considers some conditions so severe that they greatly increase the chances of being approved for benefits.
Unfortunately, many claims are denied due to insufficient medical evidence or technical issues. Therefore, it’s a good idea to work with an experienced SSDI lawyer who can help you build the strongest claim possible and guide you through the application process. If your claim is denied, we can also help you appeal. Contact Rob Levine Law today at (800) 742-3920 to learn more about how we can help.
Conditions that Qualify for Disability Benefits
The SSA maintains a guide called the Blue Book (formally titled “Disability Evaluation Under Social Security) to determine benefit eligibility. The Blue Book provides a comprehensive listing of impairments considered severe enough that individuals diagnosed with them might be presumed disabled. Having one of these conditions still isn’t an automatic qualifier for benefits. To be approved for SSDI benefits, you must meet the specific criteria outlined under each condition in the Blue Book.
Some of the common disabling conditions listed in the Blue Book include the following:
- Physical Conditions – Examples include amputations, heart conditions, chronic lung disease, and severe burns.
- Sensory Issues – Examples include severe hearing loss and blindness.
- Neurological Conditions – Examples include Parkinson’s disease, multiple sclerosis, and epilepsy.
- Cancer – Examples include malignant neoplastic diseases, such as lymphoma and leukemia.
- Mental Health Conditions – Examples include schizophrenia, autism, and major depression.
- Other Qualifying Conditions – Examples include kidney disease, lupus, and cystic fibrosis.
Each condition listed has additional criteria attached to it. For example, a person with severe burns must also be unable to use their extremities, stand up from a seated position, or maintain an upright position while standing or seated.
If the Blue Book doesn’t list your condition or you don’t meet the exact criteria enumerated, that doesn’t necessarily mean you don’t qualify for benefits. The SSA requires that you demonstrate how your physical or mental condition prevents you from working.
How the Social Security Administration Evaluates Disability Claims
The SSA receives and evaluates thousands of initial disability applications annually. The application and approval process can be time-consuming and stressful. Given that most people rely on these benefits to pay their bills, the SSA tries to issue decisions as quickly as possible.
The SSA has partnered with the Disability Determination Services, or DDS, a state-based agency that evaluates new SSDI applications. The DDS will review your application, medical history, and other submitted evidence to determine if you meet the basic requirements for SSDI benefits.
If the Blue Book lists your condition, the agency will determine whether you also meet the stated criteria for that condition. For non-listed conditions, the agency uses a five-step evaluation process that asks these key questions:
- Is the applicant working at substantial gainful activity? If yes, the claim is denied.
- Does the applicant have severe impairment? If not, the claim is denied.
- Does the impairment meet or equal the listing? If yes, the claim is approved.
- Does the impairment allow for past relevant work? If yes, the claim is denied.
- Does the impairment allow for any other work? If not, the claim is approved.
Essentially, the SSA considers a condition disabling if it prevents you from engaging in substantial gainful activity, or SGA, and is expected to last at least 12 months or result in your death. Substantial gainful activity is a job in which you earn more than a set monthly threshold. A condition is not considered disabling if you are capable of performing SGA.
How Do I Know if I Qualify for Social Security Disability Benefits?
When an injury or illness prohibits you from being able to work, qualifying for disability benefits can help you pay your monthly expenses. The first requirement to qualify for SSDI is that you’ve paid enough into the system by working in jobs where a portion of your payroll withholdings are sent to Social Security.
The next requirement is that you have a qualifying medical condition. Regardless of whether the Blue Book lists your condition, having strong medical evidence is a must. Substantial documentation is necessary to prove that your impairment is severe enough that you cannot perform your current work or any other type of work for which you may be qualified.
Any other information that may be relevant to your case is critical to include with your application. For example, it’s helpful to document your full work history to prove you can no longer perform any of those physical or mental activities due to your condition.
What Happens if My Social Security Disability Application is Denied?
It can be disappointing to do so much work on your initial application only to have the SSA deny your SSDI claim. It may ease the blow knowing that a significant percentage of initial SSDI claims get denied due to lack of evidence, incomplete documentation, or various administrative issues.
Fortunately, you can appeal the decision if you act quickly. From the date you receive a notice of denial, you have 60 days to file a request for reconsideration, which triggers a fresh review of your claim by a different evaluator. If this process isn’t successful, you can request a hearing in front of an administrative law judge, who can hear testimony from you and expert witnesses and review additional evidence.
SSDI appeals can be intimidating, and you don’t get a second chance if things don’t go your way. Our skilled SSDI benefits lawyers can put together the strongest case possible to give you the best chance of getting the benefits you need.
How Can a Social Security Disability Lawyer at Rob Levine Law Help?
Social Security Disability requirements can be confusing, and the benefits application process is challenging. An SSDI lawyer can advise you of your rights and submit a complete and accurate disability application with supporting documentation on your behalf. If your claim gets denied, we are fully prepared to pursue a favorable result through an SSDI appeal.
At Rob Levine Law, we have worked hard for clients nationwide for over 25 years. Our knowledgeable attorneys have over 75 years of combined experience, helping thousands of disabled veterans, injury victims, and clients in need of SSDI benefits secure billions of dollars in settlements and verdicts.
Our firm takes pride in offering personalized client services, meaning you never have to struggle to get a return phone call or status update on your case. We are passionate about using our knowledge and skills to secure just compensation for our clients.
Contact a Social Security Disability Lawyer at Rob Levine Law Today!
At Rob Levine Law, we believe that everyone deserves the right to collect the full benefits they are owed. If you need more information about what qualifies for disability or help proving your case to the SSA, we can help.
Our firm will help gather the evidence necessary to prove you are a strong candidate for SSDI. We will also serve as the legal advocate you need during this trying time. We don’t charge you anything upfront for our services, and you don’t pay us anything unless we win benefits for you.
Call us today at (800) 742-3920 or contact us online to schedule a free initial consultation.
