If you are unable to work due to your medical condition, you may have considered filing a disability claim for Social Security Disability (SSD) benefits. But what does it take for a disability or illness to qualify for SSD benefits? And how do you go about applying?
Claiming Disability Benefits
Eligibility for SSD benefits requires that you have a disability that has lasted, or is expected to last at least 12 months, or is expected to result in your death. The Social Security Administration Blue Book contains more than 100 disabling conditions which, if all of the criteria are met, make an applicant eligible for SSD benefits.
The Blue Book covers all major bodily systems and includes conditions such as:
- Amputations, fractures, soft tissue injury or reconstructive surgery;
- Loss of speech, hearing loss and difficulties with vision;
- Cystic fibrosis, asthma, and lung transplants;
- Heart transplant, heart failure and symptomatic congenital heart disease;
- Inflammatory bowel disease, gastrointestinal hemorrhaging, or weight loss due to any digestive disorder;
- Chronic kidney disease;
- Disorders of bone marrow failure and anemias;
- Burns, photosensitivity disorders and chronic infections of the skin or membranes;
- Endocrine disorders;
- Congenital disorders;
- Epilepsy, brain tumors and cerebral palsy;
- Schizophrenia, autism, personality disorders and intellectual disability;
- Cancer, and;
- lupus, inflammatory arthritis and other disorders of the immune system.
If an applicant’s medical condition doesn’t fall within the listing, or if it doesn’t meet the criteria for a specific listing, they can still qualify if they can prove their condition equals or exceeds a medical listing (most people qualify in this manner).
The disability must also prevent you from participating in substantial gainful activity. In 2018, the SSA considers a person gainfully employed if they earn more than $1,180 ($1,970 if the individual is blind); this amount changes annually. If you meet the SSA’s disability criteria but earn more than the SGA per month, your application will be denied.
Applying for Social Security Disability
You may apply for SSD benefits online, at your local SSA field office or by calling 800-772-1213. Depending on your specific circumstances, there may be advantages or disadvantages to choosing one application method over another. An experienced SSD attorney can help you decide the best way to apply.
Regardless of which method you choose, you must provide the SSA with detailed information about your medical condition. This is more than just a doctor’s note that reads, “Patient is disabled and unable to work.” Instead, you should submit with your application every medical record that supports your disability and its impact on your ability to work. This may include, but is not limited to:
- CT scans;
- Genetic testing results;
- Detailed treatment notes;
- Dates, locations, and duration of any hospital stay;
- Current and past medications, including those tried and abandoned because they didn’t help;
- Current and past treatment for the condition, including those tried and abandoned because they didn’t help, and/or;
- Medical notes from doctor’s visits.
Your treating physician should also complete a medical source statement. Eligibility for SSD benefits is contingent not only on an applicant’s disability status but also on how that disability affects his ability to work. When evaluating an application, the SSA considers an applicant’s functional residual capacity – those tasks they can do despite the disability. While your medical records may fully support your disability, they often do not contain enough information regarding how it affects your day to day life or your ability to work. The medical source statement is designed to elicit that information from your physician to help paint a clear picture for the SSA about how your disability makes you unable to perform any work functions.
The application also requires that you submit detailed information on your employment history. Even if you meet the SSA’s stringent disability criteria, you will be ineligible for benefits if you do not have enough work credits (the amount needed varies based on the applicant’s age). The SSA will also use your employment history to see if there is any other type of work you can do consistently with your past work history, education, and training.
Disability claim wait time and success rate
How long you’ll have to wait to receive a decision on your SSD benefits application varies based on the workload of the SSA office handling your application, the completeness of the information provided in your application, and whether the SSA needs to request copies of your medical records, among other factors. Generally, you can expect to receive a decision anywhere from three to five months after you submit your application.
The chance that your SSD benefits application is approved is low – though approval rates vary from state to state, on average only 36-percent.
Need help navigating the complex world of Social Security Disability applications? Contact a law office with experience and compassion to help you with your case. Fill out our online form or call us today at #800-419-7606.