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How Does Social Security Determine You Are Disabled?

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If you’re disabled and no longer capable of working you may be asking how the SSA decide if you’re disabled and no longer able to work. You may be surprised to know that there are many steps to disability approval, and no two cases are the same. The Social Security Administration (SSA) will utilize its own manual, evaluation, and applicants work history to determine if you’re disabled and unable to sustain employment.

Determining Eligibility

The SSA basically follows a five-step process to determine eligibility for disability benefits. These steps are as follow:

Step One: The SSA Decides if You’re Working

Is the applicant working – if you’re still working you will not qualify for Social Security Disability (SSD) benefits? The SSA defines “work” as earnings approximately $ 1,310 per month in taxable income. If you’re able to earn this despite your disability, whatever your medical condition may be, you will not be approved for Social Security benefits. If you’re not working, the SSA will then send your application to Disability Determination Services (DDS) to make a ruling on your medical condition.

Step Two: DDS Determines if Your Condition is “Severe”

Only severe medical conditions will be approved for disability. What does the SSA consider to be severe? If you’ll be out of work for least 12 months or if you have a medical condition that will result in death (like metastatic cancer or ALS), you will be approved. Minor medical conditions that heal quickly like broken limbs will not qualify. If you’re still able to walk, lift weight, type, use a phone, and perform many normal daily activities, it’s unlikely that the DDS will approve your claim based on its medical severity.

Step Three: The SSA Reviews the Blue Book

The Social Security Blue Book is the SSA manual on conditions that qualify for disability benefits. The Blue Book contains hundreds of medical conditions that can potentially qualify for benefits, including the test results or symptoms you’ll need to be approved.

The Blue Book qualifications will vary depending on your diagnosis. For example, applicants with advanced cancer will automatically medically qualify, and should even have their claims expedited. The SSA uses complex programs to flag applicants who clearly have a severe medical condition to expedite their approval process. If you have another condition, such as a spinal cord injury or back condition, the SSA will compare your abilities to its own listing in the Blue Book. If your symptoms and objective testing “match” the necessary Blue book criteria, you should be approved. Unfortunately, 95% of the applicants don’t meet the SSA Blue Book criteria in Step Three. If not, you’ll need to move onto Step four in the Five Step process.

Step Four: The SSA Reviews Your Past Work History

You may still be approved for disability benefits even if you don’t meet a Blue Book listing if you can prove you cannot maintain employment with your disability. For example, a cashier who’s on her/his feet all day may not be able to work while she’s undergoing chemotherapy due to the nausea and other severe side effects. Earlier stages of cancer don’t always qualify under the Blue Book criteria, but if you still cannot work for a least one year you can be approved.

Step Five: The SSA Determines if You Can Do Any Other Type of Work

If you cannot perform your current job, the SSA will finally determine if there are any other suitable employment options for you. If the applicant is found to not be able to do their past relevant work, SSA or Administrative Law Judge must determine whether they can do any other work in the national economy, considering that person’s age, educational background, work experience and, of course impairments. Let’s go back to the cashier example, if the applicant graduated from college with a degree in business studies three years before receiving cancer diagnosis, the SSA may argue that while she cannot remain a cashier during her cancer treatment, she could still find a suitable job with less physical demands, like working as a secretary or in a similar office setting where the work is sedentary.

The process of applying for social security disability can be overwhelming and up to 70% of initial applications are denied. Before you invest a great deal of time in applying for disability benefits, be sure to consult with Legler, Murphy & Battaglia, LLP at 941-748-5599 to help navigate through this difficult process.

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