When can I apply for the Social Security Disability? When should I apply? What is the likelihood that I will be found disabled? Do I really need an attorney or legal representative? I get these questions frequently from prospective clients. My next three blog entries will address these and other questions related to social security disability.
People often wonder the answer to these questions, especially when they are facing a prolonged illness or medical disability that is keeping them from their regular work. Often, people call our office and ask these same questions. In these first two posts, we will answer these questions, and alert you to other important considerations you may not be aware of when trying to decide whether to apply for social security disability or whether you will win your claim after you have applied. In the third post, we will discuss an example that may have some similarities to your situation.
First we need to consider what disability means, at least to theSocial Security Administration. It means something very specific and is likely different than what you may think. Understanding what Social Security means by disabled is an important part of your case. In other words, how does Social Security decide if you are disabled or not?
Social Security defines disability as the inability to engage in substantial gainful activity by reason of any medically determinable physical or mental impairment or combination of impairments that can be expected to result in death or that has lasted or can be expected to last for a continuous period of not less than 12 months. Take a look at the expanded definition on the Social Security's website at Disability Planner: What We Mean by Disability. This definition is packed with technical terms that can really cause problems in your application if you do not understand them properly. Let's take a look at some of these.
Substantial Gainful Activity means that a Claimant (the person applying for disability) is (1) working and (2) earning more than a certain amount of income per month. What is very tricky is that the amount changes from year to year. If you earn more than the amount set by Social Security, then it does not matter what medical problems you have, the Social Security Administration will not find you disabled. In other words, your own work activities and desire to remain employed can be used against you in determining whether you will qualify for benefits.
Your medical impairment (illness or injury) must meet the Social Security's twelve month requirement. Simply put, no matter how bad your medical condition is, if it is not expected to last more than a year, you will not be found disabled. While there is no hard and fast rule as to how the Social Security Administration looks at this requirement, practically speaking, very seldom is there a situation where the Social Security Administration looks out into the future and makes a prediction as to whether your medical condition will last the next 12 months. Rather, it seems to be much more common for the Social Security Administration to not find you disabled until your medical impairment has kept you from working for 12 months already. There is more on this below.
Medical Condition(s) means that you must be able to show with medical records that (1) you have a health problem and (2) that your health problem prevents you from working. This means that your doctor(s) must clearly explain why and how your condition affects your ability to work. This is the most complicated part of your social security disability claim. Sometimes your doctor(s) need help with this by someone who is trained to know what the Social Security Administration is looking for. The link in this paragraph will connect you to the Social Security's complete listing of recognized impairments and medical conditions and what is required to be shown for each type of health problem.
With these strict requirements what is the likelihood that you claim will be approved? Like any lawyer, I will tell you, it depends. Statistically speaking most claims are denied. Even the Social Security's website acknowledges it follows a strict definition of disability. There are three basic stages to a social security application: (1) the initial application; (2) a request for reconsideration; and (3) a request for a hearing. Even after this last stage, your claim can still be denied. Although you have further appeal options, those options are beyond the scope of these initial blog posts. In the early stages (1) and (2), denials range from 75% of claims and higher. It is tough.
You also should know that your social security disability application file never goes away. This means that from the time that you file your first application for disability, a file is created for you. This file never goes away. Even if your claim is denied and you reapply, it is all a part of the same file. This is important because questionnaires the Social Security Administration sends to you and other documentation that you provide or give them access to, are always available for their review and consideration. Sometimes, not just what you say, but how you say it can be an important consideration in whether you will be found disabled. The third blog post discussing social security disability will give a good example of this.
You may be thinking at this point, why even bother with applying? That is a good question, but legitimate claims are approved every day. So, how can you ensure you claim is one of the few that is approved?