father and sonFive Criteria Determining Disability Benefits

People tell us all the time that their disability application was denied but that they have a neighbor or friend or enemy who got their benefits. Trying to understand how the SSA determines benefits can be difficult because so much of it depends on the caseworker’s personal interpretation of your medical records. However, there is a basic five-step checklist the SSA uses to determine whether benefits should be given or not. If you pass all five checks then you should be given benefits, although we find that this is not the case every time, thus the reason so many people need a lawyer to assist them in appealing their case. This checklist is generally sudden death- fail one criteria and benefits are usually denied.

 

  1. Working
    The first thing the SSA checks is if you are currently employed earning more than $1,070 per month or more than $1,800 if you are blind (2014 criteria). Earn more than these amounts and the application can be denied right here.

  2. Severity of Medical Condition
    “Severe” is the word the SSA uses to describe eligible medical conditions. They stipulate that the condition has to be bad enough that it significantly limits your ability to perform activities associated with work such as memory, sitting and walking. The condition has to last longer than a year (so pregnancy does not qualify).

  3. On the List?
    The SSA maintains a list of impairments that they deem severe enough to qualify for disability benefits automatically. It is a very detailed list. For instance, a person suffering from seizures must be taking medications for seizures and must still be having seizures that interfere with their work. Minor, or petit mal, seizures must occur more often than once per week even when the person is taking their medication properly for them to qualify for Social Security disability benefits for seizures. If your impairment does not match the list expect to be denied. (Hint, most people’s impairments don’t match the list exactly.)

  4. Work History
    The SSA wants to know if you can continue to do the work you were doing before your disability. If you used to perform data entry while sitting at a computer and you can still sit at a computer and enter items into a computer but for a different employer, with adjustments to your work area, and/or a different environment then you may not be granted benefits.

  5. What Can You do Now?
    The next item on the checklist, if you made it this far, is the gut wrenching, “Can you do ANY type of work?” Here your work experience, level of education, age and skills all get tossed into a “salad bowl” along with your disabling condition. If the SSA feels after mixing the items together that you can still do some type of work then they can deny your application.

So you see there are pitfalls at every turn. Most applications are denied in a simple routine. Don’t take it personally and don’t think that some caseworker sitting in a little cubicle is out to play favorites with your neighbor. When caseworker denies a disability claim they are simply doing what they have been instructed to do- determine if a person meets a five-point checklist.

Not the End!

Thankfully, that is not the end of the story. After your initial application is denied you are allowed to appeal. However, the exact same checklist is used so most applications are denied once more. But the next appeal is your opportunity to shine. You will be able to personally talk to someone and explain your side of the story. The same five criteria is used against you during this appeal, but now you can explain how you fit the criteria, instead of simply relying on caseworkers to connect the dots.

Can a Lawyer Make a Difference?

A good Social Security disability lawyer knows the ins and out of SSDI law. They know how to connect the dots in a precise and detailed way to refute government witnesses and evidence that may be preventing you from receiving your benefits. Sometimes medical evidence is overlooked. Sometimes it is misunderstood. Sometimes it just needs to be explained in a way that decision makers can understand it. This is where a lawyer can help you. Is the cost of hiring a lawyer worth it? Well, if it means the difference between getting benefits or not… Remember, the Cochran Firm disability lawyers will not charge you a fee if you do not win your benefits.

 

 

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About the Cochran Firm Disability Lawyers

Recognized as one of the nation’s premier law firms, The Cochran Firm handles cases on behalf of clients seeking a Personal Injury Lawyer, Criminal Defense, Medical Malpractice, Bankruptcy Attorney in Atlanta or Social Security Disability Lawyer.The Firm can be reached at 1-800-THE-FIRM (1-800-843-3476) or fill out the form on this page. “Working for You.” Article by Benjamin A. Irwin.


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