Defining disability isn’t as straightforward as consulting your dictionary. The medical field defines disability as a physical or mental impairment restricting one or more major life activities, such as working, walking, seeing, or hearing. However, the Social Security Administration takes a more stringent view of the definition of disability—meaning that even if your doctor diagnoses you as disabled, your condition may not be eligible for benefits. It’s highly advisable to have a qualified Cleveland, OH social security disability lawyer assess your case before seeking benefits. Schedule your free claim review.
How Social Security Defines Disability
The Social Security Administration (SSA) has further requirements for qualifying as disabled. When applying for Social Security Disability Insurance (SSDI), your condition must meet three specific criteria:
- You have a physical or mental condition preventing your ability to perform the same type of work you did before you became ill or injured.
- Your condition prevents you from adjusting to other types of employment.
- Your condition has lasted or is expected to last at least 12 months or is diagnosed as terminal.
Age, education, and past work experience all factor into whether or not disability benefits are allowed. It is acknowledged and accepted that older adults (over 50), or people who are less educated or have fewer transferable skills, will experience more limited options when looking for new work accommodating their condition. That means they’re more likely to be approved for disability than those who are younger or with higher education or transferable skills—even when claimants suffer from the same medical or mental health condition.
Social Security’s Sequential Five-Step Evaluation Process
Social Security utilizes a sequential five-step evaluation process to decide whether your condition qualifies for disability. When an SSA adjudicator determines eligibility at any step, they continue to the next until all five steps confirm that your condition qualifies as a disability. The SSA’s five-step evaluation process is as follows:
- Substantial Gainful Activity: The SSA measures your work activities and earnings per their Substantial Gain Activity (SGA) regulations. If your earnings fall under the SGA monthly limit, their adjudicator moves to the next step. If it exceeds, they will not qualify your condition as a disability. The SGA amounts increase annually.
- Severity of Condition: During step two, the SSA evaluates the severity of your medical or mental health condition. Your condition must interfere with basic work-related activities and have lasted or be expected to last 12 months or be terminal to qualify. An experienced disability attorney will review medical records with medical professionals and your treating providers to ensure accuracy.
- Blue Book Criteria: At step three, they review whether your condition meets the medical criteria detailed in the SSA’s Blue Book of Impairments. A Social Security disability lawyer will ensure your treating doctors provide critical, detailed medical documentation. They also collaborate with a network of medical professionals and expert witnesses who will review your disability claim before it is submitted.
- Past Relevant Work (PRW): The SSA adjudicator assesses your residual functional capacity (RFC) to decide whether you can perform your past relevant work (PRW) responsibilities. The fourth step compares your RFC and PRW function by function.
- Professional Adjustments: Finally, the SSA evaluates your RFC, age, education, and work experience to investigate if you can make any adjustments to find alternative work that you can perform. If the adjudicator does not find an adjustment for other work opportunities, claimants will be considered disabled.
If, at any step, it is decided that you are not disabled, the adjudicator will cease the evaluation and deny your disability claim. Thorough medical documentation, employment history, and accurate form completion are vital before submitting claims to undergo the process.
How to Prove Disability for Social Security
Proving you meet the SSA’s definition of disability is challenging—roughly two-thirds of applicants are initially denied. Unless you are suffering from a terminal illness or a medical condition that qualifies for compassionate allowances, you must provide extensive documentation of your condition and how it prevents your ability to continue working. Evidence that helps prove disability includes:
- Medical Records: Your detailed medical history, including diagnoses, treatments, procedures, diagnostics, imaging, progress notes, and prognosis, is the cornerstone of the SSA’s disability determination process.
- Letter From Your Doctor: A letter from your physician outlining your medical or mental health condition, functional limitations, and how it affects your ability to perform daily tasks helps prove your disability.
- Residual Functional Capacity (RFC): Your doctor will complete an RFC evaluation to assess your ability to work despite physical or mental limitations.
A letter from your employer demonstrating when your condition began to impact your working abilities is also viable evidence for your disability claim. A daily health log monitoring quantifiable data, such as blood pressure and blood sugar levels, can also establish disability. Bring all evidence of your condition to your free claim review with a Social Security disability lawyer.
How Hiring a Disability Attorney Benefits Your Claim
Consulting a Social Security disability lawyer can be very helpful if you need approval for disability. They assist with completing the form and double-checking it for accuracy before submission. An attorney may also help schedule medical appointments to assist clients and obtain necessary medical documentation. Other benefits of hiring an experienced disability lawyer for your case include the following:
- Compelling Medical Evidence Collection: Attorneys carefully review medical documentation with expert healthcare professionals to ensure there isn’t missing information, unexplained gaps in treatment, or other potential issues. Necessary documentation for compelling medical evidence includes diagnoses, treatments, procedures, rehabilitation, physician notes regarding pain management and impact on daily life, and prognosis.
- Hearings Preparation and Representation: Before claimants attend hearings, such as their hearing with an Administrative Law Judge, disability lawyers will prepare them. This includes conducting mock interviews so that you are comfortable and clear when answering questions. During hearings, attorneys may cross-examine medical and vocational experts to strengthen your claim.
- Filing All Necessary Appeals: Since only one-third of initial disability claims are approved, it’s vital to have a strategy for appeal. A Social Security disability lawyer handles all appeals, including filing and completing them within deadlines and communicating with the SSA on their client’s behalf.
When appeals fail, a disability lawyer can file a civil lawsuit to pursue the benefits you deserve. Disability applicants with attorneys are three times more likely to be granted benefits. If your injuries or illness prevent you from returning to work, or if your condition is terminal, you should speak with an experienced disability attorney. Schedule a free consultation to get started on your claim today.
