Good Signs That You Will Be Approved for Disability
But what if you needed to apply for disability? How can you improve your chances of being approved?
When individuals apply for disability, they first ask whether they will be granted benefits. Unfortunately, your chance of being accepted at the outset stage of the procedure is not good.
Roughly 36% of people who apply for disability benefits are approved at the initial application stage. However, the approval rating increases for cases that are appealed. More than 50% of people who appeal a denial to an administrative hearing have their applications approved.
While no attorney can guarantee that your application for social security disability benefits will be approved, several factors help to improve the chances of approval. First, the rate at which awards are granted improves if you appeal the first denial, but it does not change much. According to recent SSA data, the administrative hearing level has a better success rate.
Your condition as a disabled person is recognized by the Social Security Administration.
If a person’s impairments are expected to last for at least 12 months or result in death, he or she may be eligible for Social Security disability benefits. This implies that you must have a long-term disability; a short-term disability does not qualify.
More than 100 medical conditions, according to the Social Security Administration’s Blue Book, are considered disabling. Each ailment has its own set of standards that applicants must satisfy via medical evidence to show their disability. However, fulfilling these requirements does not guarantee that the SSA will declare you disabled enough to receive disability benefits.
The Blue Book explains the medical criteria you must meet to get approved for disability benefits. This includes the symptoms you must have and the test results (including diagnostic imaging) you need to qualify for disability from arthritis.
Physical abnormalities can be seen in the following listings:
- Depression, anxiety, manic-depressive illness, or posttraumatic stress disorder that can all cause mental disability.
- Coronary artery disease or hypertension that can lead to heart problems.
- Multiple Sclerosis (MS) or ALS>
- Down Syndrome
- Traumatic brain injury, post-concussive syndrome, and other neurological sequelae
- A severe case of stenosis necessitates a laminectomy or spinal fusion, in which metal plates are used to create a wall between the nerve roots and the narrowing.
These are just a few of the various ailments that can qualify you for SSA disability benefits. The full list of the qualifying conditions is available on the SSA’s website.
Even if you do not have a medical issue on the list, you may still get compensated if a listed issue caused your injury. However, meeting an issue on the list improves your chances of receiving disability compensation.
A listing may be met from a medical standpoint, such as through workplace adjustments, treatment, or an ability to adapt to or work around any discomfort. However, fulfilling the criteria for a specific issue boosts your chances of being accepted.
You earn less than substantial gainful activity
Having a recognized disability on its own isn’t enough to qualify someone for social security disability benefits. You must also show that the disability obstructs your ability to work. More precisely, you must be unable to participate in what the SSA refers to as a significant gainful activity (SGA) for 2020 (i.e., earning more than $1,260 per month, or $2,110 if blind).
For the year 2022, non-blind applicants’ monthly SGA payment is $1,350, whereas blind applicants’ monthly SGA amount is $2,260. As a result, you may get disability even though you are employed if your earnings fall below this amount.
Monthly earnings below the SGA threshold aren’t sufficient to guarantee eligibility for disability benefits. However, having earnings that exceed the SGA threshold does not immediately disqualify you.
To begin, earning less than SGA does not guarantee your disability claim’s approval. You must still provide evidence that your medical condition impedes you from working and performing basic daily living activities.
The Social Security Administration (SSA) may declare that you are disabled if your monthly earnings exceed SGA. Still, you were granted special accommodations, worked irregular hours, or required frequent breaks to work. For purposes of calculating monthly income for SSDs, certain payments that are not considered income for income tax purposes (like alimony payments) are not included.
The Social Security Administration treats earnings and income differently. For example, the SGA calculation does not include workers’ compensation benefits (like a structured settlement), employer retirement pensions, and long-term disability payments.
Additionally, even if you earn less than SGA, you may still be ineligible for benefits. For example, if the SSA determines that you could perform other work or continue in your current position with modifications. However, earning less than the minimum wage when applying for disability proves that your application will be accepted.
You have adequate work credits
Social Security disability insurance is similar to an insurance policy because it provides benefits when you need them the most. Individuals contribute to Social Security by working covered employment, and earning credits are converted into money. In 2020, $1,410 in earnings corresponds to one credit (like SGA, the value changes yearly). You can earn no more than four credits each year.
The SSA will set the requirement on how many credits you need to qualify for disability insurance benefits based on when you claim you became disabled. In general, you must have at least 40 work credits in your last ten years, with 20 of those credits earned during that time period.
Younger workers claiming disability, on the other hand, may qualify with fewer recorded work hours. The amount needed varies by age and is as follows:
- Younger than 24: Six credits in the three years prior when your disability began
- 24 to 31 years old: To be eligible for Social Security Disability Insurance, you need to have worked for at least half the time between the ages of 21 and when you became disabled. For example, if the disability occurred at age 29, you would need to have worked for four years total and earned 16 credits.
- 31 to 42 years old: Minimum of 20 work credits
- Older than 42: You need a certain number of work credits to qualify for Social Security. This number depends on how old you are. Every two years, the number of credits you need goes up by two. For example, a 50-year-old would need 28 credits.
You cannot do any work within your skillset
Eligibility for social security disability approval does not just require a conclusion that you cannot do your current work; the SSA must also determine that you cannot work at any of your prior occupations. The SSA will evaluate your age, education, experience, and prior employment history in order to see if there is other work you can do if the answer is yes. Your application will be rejected if the answer is yes.
For example, let’s say you work in food service and your disability prevents you from operating friers or grilling machinery and lifting heavy objects. However, your work experience shows that you held various jobs in administrative or customer service roles, none of which needed you to operate fry machines or lift heavy objects. Therefore, the SSA would potentially consider you able to do your prior job skills and deny your application.
Suppose your disability prevents you from doing basic chores like sitting still for lengthy periods or doing basic administrative work. In that case, the SSA will find that you could not perform any of your previous work, and your application would most likely be accepted.
You Are Over 50
As you get older, the Social Security requirements make it simpler to qualify for disability. These regulations are called “Grid Rules.”
It becomes simpler for many at age 50, then it does again at 55 and yet again at 60. If you are 50 years old or older and suffer from a significant medical condition that prevents you from performing any job you have held in the previous 15 years, you may consider trying to apply.
Even if you are a youngster, you might be entitled to disability. You do not have to demonstrate that you are bedridden; all you have to show is that you cannot resume your previous work or full-time employment.
You have consistently received medical treatment and can offer records and reports from your doctor.
The SSA relies on medical records in many claims decisions. As a result, there’s only a slim chance you’ll be approved if you don’t provide medical documentation.
We recommend submitting a lot of information and documents with your disability application. You should keep supplementing the evidence as you keep getting treatment.
To strengthen your disability claim, you must provide the following medical records and reports:
- Office visit notes
- Reports from your orthopedic surgeon or neurosurgeon regarding surgeries
- Diagnostic reports (x-rays, MRIs, and CT scans)
- Pharmacy records recording prescription medication taken
- Functional Capacity Evaluation (FCE) reports
- If you received a permanent impairment rating as part of a workers’ compensation case, it would be used to calculate your benefits.
Furthermore, we propose requesting that your doctor submit a survey or fill out a questionnaire regarding any pertinent impairment description, diagnosis, and physical and mental work restrictions. This document is referred to as a doctor’s disability letter.
If you have an injury or illness that prevents you from engaging in certain types of work, the SSA is more inclined to accept your disability claim based on the opinions of a treating doctor.
- Long-term treatment (more than one year)
- You’ve seen the doctor at least three times throughout this time (once every two to three months)
- The physician has ordered the appropriate tests and examinations for you. For example, if you have a knee injury, your family physician may have referred you to an orthopedist. If you have a traumatic brain injury (concussion), your family physician may have referred you to a neurologist.
- The doctor is a specialist rather than a general practitioner.
- You’ve received medical treatment to attempt to recover, not just to obtain disability opinions.
You should start to treat your issues as early as possible. Private or government-funded health insurance coverage through Medicaid, Tricare, or the Veterans Administration makes this easy.
You have not been able to work for at least 12 months because of your health.
The Social Security Administration does not provide temporary or partial disability benefits. Rather, you must show that your medical conditions have continued or are expected to continue for a year.
To be approved for Social Security Disability Insurance (SSDI), it is important to provide evidence that you have been unable to work for at least 12 months or that you have permanent impairments that prevent you from returning to your previous job.
Furthermore, we encourage you to obtain a letter from your medical practitioner stating how long your disability will last.
You were forced to leave your last employment for health reasons.
To be approved for disability, your testimony is very important. However, it is not usually enough on its own. You need to provide examples to support your case.
Suppose you can show that you struggled the previous few months while working or that your employer disciplined or terminated you because you could not perform as expected. In that case, you have a stronger disability claim. Indeed, a former employer’s affidavit or testimony that your performance fell as you became sicker puts you in a better position to succeed.
If you claim you tried to return to work and failed due to a mental or physical problem, it’s acceptable for a third party to authenticate the fact.
The doctor thinks you meet the requirements for disability.
Before deciding on your disability claim, the SSA may request a consultative examination.
A consultative exam is a medical examination given by a specialist with expertise in treating similar issues as those you claim disable you. Although your treating physician may be the consultant, I find it more common for an unfamiliar doctor to do the examination. Indeed, when you fail to provide opinion evidence or sufficient office visit notes from your treating physicians, the SSA commonly demands a consultative examination.
The consultative exam physician will write a report after the evaluation. The report will state whether they find you credible, what your diagnosis is (in their opinion), and state your limitations.
If the doctor’s examination determines that you have a condition that meets the SSA’s definition of disability, your application for SSDI or SS is likely to be accepted.
You’ve hired a social security disability lawyer.
Finding a Social Security disability lawyer to advocate on your behalf indicates that you’ll be granted approval. Indeed, studies have shown that individuals with legal counsel were almost twice as likely to receive approval for disability.
There are a few possible reasons for this.
The first consideration is that most disability attorneys operate on a contingency fee basis. You only pay a fee if you win. As a result, disability lawyers are more likely to accept claims with merit than non-disabled individuals because they save time and money.
Second, an attorney specializing in representing clients in obtaining Social Security benefits will ensure that you have the most thorough medical and occupational documentation available. The lawyer understands what you require and how to demand it. And she or he knows when documents must be submitted or subpoenas requested.
Third, a seasoned disability advocate will be aware of the judge who will hear your case. This understanding may assist you in effectively presenting your case at the disability hearing (if one is required).
Fourth, your attorney will know how to cross-examine the expert who will be asked hypothetical questions at your hearing. They’ll understand which inquiries and restrictions are most likely to determine that you’re disabled.