When a person can’t work, or has a significant drop in their ability to work at the same level that they once did due to a disabling condition they will often take advantage of disability benefits from the Social Security Administration in order to help make ends meet. However, getting these benefits isn’t easy. There is a complex application process that requires extensive documentation before a person can be considered to receive benefits. Even though the Social Security Administration offers a detailed checklist of information needed, most people are initially denied benefits even when they have a very legitimate claim.
Social Security Administration Disability Definition
The Social Security Administration doesn’t look at the term “disability” in a medically traditional sense. To them, it all comes down to a person’s ability to work and make a living in a way comparable to how they were before the disability.
There are three basic criteria that the SSA will look for when considering an application for disability benefits.
- The inability to do the work that was done before
- The inability to adjust to other work due to your medical condition
- The disability has lasted or is expected to last at least a year or result in death.
Part of the reason for the strict criteria is to encourage people to work if they can and to prevent the approval of permanent benefits for those who may only be disabled temporarily. When a person is temporarily disabled, the SSA assumes that resources such as worker’s compensation, short term disability insurance, and personal savings will be able to help that person overcome their temporary obstacle.
Medical Proof of Disability
To be eligible to receive benefits, you must have extensive medical documentation from acceptable medical sources demonstrating the nature and extent of your disability. This may include doctor’s examination records, biopsy results, blood work panels, imaging reports (CT or MRI scans, X-rays, etc.), and mental health records. The documents should be include fairly recent reports: six months old or less at the time of application. Older documents are also relevant, as they help establish the severity and length of the disability. The more official medical documents you have proving your condition, the better.
Social Security Disability For Those 55 Years Old Or Older
Under Social Security rules, the older you are the easier it becomes to secure Social Security Disability benefits.
At age 55 or older, you may qualify for benefits if you are unable to lift 25lbs frequently and cannot be on your feet for most of the day.
Generally, even if you are able to do very light deskwork and are at least 55 years old, you may still qualify for Social Security Disability benefits.
Sufficient Work Credits to be Eligible for SSDI
Only persons with “insured” status may receive disability benefits. You have reached insured status if you’ve worked a certain number of years and contributed a specific amount to the social security system prior to filing for disability benefits. The SSA determines this amount by converting your earnings into work credits. The older you are, the more work credits you need to be insured. To find out the number of credits you need to qualify, review this page on the SSA site.
Application Process
Applying for Social Security benefits is usually a very long and tedious process. It begins with filling out an online application, or mailing an application if that is not possible. Along with the application the applicant must provide extensive information about their work and medical history as well as other personal information about their citizenship, marital status, military service, their children, bank information, medical information, educational information, and their job history.
Sometimes, when there is an obvious piece of missed documentation, the SSA will send a reminder asking the person to provide what is missing. After all this, over 62% of Social Security Disability Applications initiating in New York State will be denied.
A Second Try
After a denial, an applicant can begin the appeal process and request reconsideration. More than 85% of reconsiderations are denied.
Disability Hearing
The next course of action is to request a hearing with a judge who is not directly connected with the SSA, but has a high level of knowledge regarding the requirements. Here, the applicant has an opportunity to go through a five-step evaluation process, which includes meeting with claimants and listening to witness and expert testimony. Judges seek out information from a claimant’s personal physician, while the SSA does not.
Keys to Approval
Getting a hearing date with a judge may take between six months and two years. During this time, it is a good idea for an applicant to speak to an attorney if they have not already done so. The sooner an attorney gets involved in the process, the better chance an applicant has of approval. When applicants take the time to go through the hearing process, New York approval rates jump to over 53%. This includes applicants that hire an attorney, and those who attempt to represent themselves, so chances of approval with the help of a lawyer are likely even higher.
Fighting for Social Security Disability can be an uphill battle. The Social Security Administration can be very particular about what they will accept as proof that you will not be able to work at a job with comparable pay to what you were earning before you became disabled. Most applications are initially denied, and will require that you go through an appeal process in order to have a chance of receiving benefits.
When an initial request doesn’t go through, working with a social security disability at Paul Giannetti Attorney at Law in Albany, NY can often make a difference when it comes to resubmitting evidence of your disability and convincing the Social Security Administration to grant you the assistance you need. If you need help with the application or appeal process, contact us to set up a free consultation.