Disability benefits are not easy to get. The Social Security Administration is thorough and requires extensive medical documentation in order to prevent fraud.
When you file for a claim, the SSA sends your file to the Disability Determination Service for medical review. There is a 5-step process for determining the validity of a claim:
- Substantial gainful activity - If you're currently working or have worked since applying for benefits, and you've earned at least $1,170 per month, then you've been engaging in substantial gainful activity. This will disqualify you for benefits even if your injury meets all other requirements.
- Severity of impairment - A medical consultant or claims examiner of the DDS will look over your medical documents to determine the severity of your injuries. In order to be eligible for a claim, this representative must determine that your injuries are severe or incapacitating.
- Listing of impairments - Next, the DDS representative will compare your disability to the official Listing of Impairments. For each listing, there is a corresponding degree of severity which must be met in order to qualify for disability benefits. The representative also has the freedom to make their own determination if none of your impairments match an official listing but the professional feels they are severe enough to qualify.
- Performing past work - If your impairments do not qualify for any of the above listings, the examiner will move on to this step. He or she will determine if your impairments are severe enough to prevent you from performing any of the jobs you've held in the past.
- Performing any work - If your impairments are determined to be severe enough to prevent you from completing your past job, the consultant will determine if there are any other jobs in the U.S. which you are capable of performing. If there are, you will be denied a claim. Exceptions may apply for older workers.
Preparing For A Claim
If you're planning to file a disability claim, it's important to gather as much relevant information as possible. Many claims are denied simply because the claimant failed to provide sufficient medical evidence. Keep all records from the start of your disability onset date. If you're not sure what that date is, talk with loved ones, employers, or coworkers for guidance.
Make sure to follow your doctor's advice to the letter. Take the medication they prescribe in the right amounts and at the right frequency. If you fail to follow medical advice and your condition doesn't improve, the SSA will view this as your own fault and likely deny your claim.
Journaling can be effective for keeping a log of your symptoms and your overall experience after the onset of your disability.
What If My Claim Is Denied?
When you're injured and unable to work, a claim denial may seem like the end of the world. While it's understandably stressful, there is still hope. Remember, most claims get denied the first time. You have 60 days to file an appeal after being denied - and we recommend acting as quickly as possible. The appeals process is lengthy and you want to do all you can to shorten it.
If you decide to appeal, you will need to enlist the guidance of an experienced social security disability lawyer. This lawyer will work with you to compile as much evidence as possible in order to win an appeal. Taking on the SSA may seem like a daunting task, but an experienced lawyer will know what they need to prove in order to win your claim.
If you haven't yet filed your claim, we recommend retaining a lawyer to guide you through the process from the beginning. Having experienced legal counsel by your side is the best way to avoid the appeal process altogether.