The Social Security Disability application process can be
confusing, stressful, overwhelming and lengthy. It is often hard for
disability applicants to navigate their own responsibilities regarding
their disability claim, let alone try to understand how the SSA will
decide whether they will approve or deny their claim for benefits. If
you are applying for disability benefits and want to understand how the
SSA reviews and approves claims for disability benefits, the following
information can help.
What Does the Social Security Administration Look For in a Disability Claim?
There are a few things the SSA looks for when an applicant files a claim for disability benefits. If you are applying for Social Security Disability Insurance (SSDI), the SSA will determine whether or not you have enough work credits to qualify for disability payments. If you are filing for Supplemental Security Income (SSI), the SSA will check to see if your household income falls below the set limits.
Meeting the SSA's Disability Guidelines
If all of the other criteria set forth by the SSA are met (e.g., work credits or income requirements), the SSA will then need to determine whether or not you are disabled, the severity of your disability and whether your disability meets their specific guidelines. This is why it is crucial that you provide as much medical documentation as you can with your initial disability application.
When reviewing claims for disability benefits, the examiner reviewing your claim will refer to a published listing of impairments known as the Social Security "Blue Book." This Blue Book lists all of the disabling conditions that could qualify an individual for Social Security Disability benefits. The Blue Book also contains guidelines for each listed condition and applicants must meet the guidelines set forth in the section that pertains to their specific disability in order to be approved for benefits. For example, if you are suffering from a traumatic brain injury, that condition is indeed listed in the Social Security Blue Book. However, a diagnosis of a traumatic brain injury in and of itself will not qualify you for benefits. The Blue Book lists symptoms from which an applicant must suffer in order to qualify under this section of the publication. If you have a traumatic brain injury that does not meet the published guidelines, you will not qualify for disability benefits.
If your condition is not included in the SSA's Blue Book, you may still qualify for benefits but will need to prove that your disability prevents you from performing any type of work-related activity. In order to prove your disability and the severity of your condition to the SSA, you will need to provide as much medical documentation as possible. Make sure you include all medical records and the names and addresses of all of your doctors when submitting your application for benefits. If you have had hospital stays, emergency room visits or trips to an urgent care center because of your disability, make sure the SSA is provided with information about each and every encounter. You can never provide too much information when filing a disability claim. Provide as much documentation as possible to help the SSA approve your disability application.
When reviewing your claim for disability benefits, the SSA will also look at your work history and your age. It is sometimes easier for those who are more advanced in age to qualify for disability benefits than it is for a younger person. For example, if a fifty-year-old man who has always worked in construction suffers a back injury and is unable to perform work because of the injury, he is more likely to be approved for benefits than a twenty-five-year-old male who suffered the same injury and had the same occupation. This is because the twenty-five-year-old could, if necessary, change to a different career path and perform a different type of work, whereas it would be nearly impossible for the fifty-year-old male to make a career change so late in his life.
What to Do if Your Application for Benefits is Denied
If your initial application for disability benefits is denied, do not be alarmed. The fact of the matter is that nearly 70 percent of disability applications are not approved at the initial stage of the application process. If your application is among those that are denied, it does not mean that you can't receive the disability benefits you need. It only means that you will need to go on to appeal the SSA's decision to deny your benefits.
If you have received notice from the SSA that your claim for benefits has been denied, contact a Social Security Disability attorney. Your chances of successfully appealing the SSA's decision to deny your disability benefits are statistically higher with proper legal representation.
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What Does the Social Security Administration Look For in a Disability Claim?
There are a few things the SSA looks for when an applicant files a claim for disability benefits. If you are applying for Social Security Disability Insurance (SSDI), the SSA will determine whether or not you have enough work credits to qualify for disability payments. If you are filing for Supplemental Security Income (SSI), the SSA will check to see if your household income falls below the set limits.
Meeting the SSA's Disability Guidelines
If all of the other criteria set forth by the SSA are met (e.g., work credits or income requirements), the SSA will then need to determine whether or not you are disabled, the severity of your disability and whether your disability meets their specific guidelines. This is why it is crucial that you provide as much medical documentation as you can with your initial disability application.
When reviewing claims for disability benefits, the examiner reviewing your claim will refer to a published listing of impairments known as the Social Security "Blue Book." This Blue Book lists all of the disabling conditions that could qualify an individual for Social Security Disability benefits. The Blue Book also contains guidelines for each listed condition and applicants must meet the guidelines set forth in the section that pertains to their specific disability in order to be approved for benefits. For example, if you are suffering from a traumatic brain injury, that condition is indeed listed in the Social Security Blue Book. However, a diagnosis of a traumatic brain injury in and of itself will not qualify you for benefits. The Blue Book lists symptoms from which an applicant must suffer in order to qualify under this section of the publication. If you have a traumatic brain injury that does not meet the published guidelines, you will not qualify for disability benefits.
If your condition is not included in the SSA's Blue Book, you may still qualify for benefits but will need to prove that your disability prevents you from performing any type of work-related activity. In order to prove your disability and the severity of your condition to the SSA, you will need to provide as much medical documentation as possible. Make sure you include all medical records and the names and addresses of all of your doctors when submitting your application for benefits. If you have had hospital stays, emergency room visits or trips to an urgent care center because of your disability, make sure the SSA is provided with information about each and every encounter. You can never provide too much information when filing a disability claim. Provide as much documentation as possible to help the SSA approve your disability application.
When reviewing your claim for disability benefits, the SSA will also look at your work history and your age. It is sometimes easier for those who are more advanced in age to qualify for disability benefits than it is for a younger person. For example, if a fifty-year-old man who has always worked in construction suffers a back injury and is unable to perform work because of the injury, he is more likely to be approved for benefits than a twenty-five-year-old male who suffered the same injury and had the same occupation. This is because the twenty-five-year-old could, if necessary, change to a different career path and perform a different type of work, whereas it would be nearly impossible for the fifty-year-old male to make a career change so late in his life.
What to Do if Your Application for Benefits is Denied
If your initial application for disability benefits is denied, do not be alarmed. The fact of the matter is that nearly 70 percent of disability applications are not approved at the initial stage of the application process. If your application is among those that are denied, it does not mean that you can't receive the disability benefits you need. It only means that you will need to go on to appeal the SSA's decision to deny your benefits.
If you have received notice from the SSA that your claim for benefits has been denied, contact a Social Security Disability attorney. Your chances of successfully appealing the SSA's decision to deny your disability benefits are statistically higher with proper legal representation.
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