What Evidence Do I Need for SSDI?

What Evidence Do I Need for SSDI?

What Evidence Do I Need for SSDI? Social Security pays SSDI benefits when you have a medical condition or combination of conditions that prevent you from working.  Your medical impairments must keep you from working for at least 12 months.  Additionally, you must have worked for a certain number of years.  Generally, you need to have worked for at least 5 out of the last 10 years.  Social Security requires certain evidence to support your SSDI claim.

Non-medical evidence for SSDI:  Disability Report

Naturally, SSDI applications require a lot of information.  Part of the application process includes providing a form called the Disability Report.  This form includes information about your doctors, hospital visits and medications.  You should only include treatment information for the time that you have been unable to work.  Social Security contacts the doctors and hospitals you provide in the Disability Report.  If you don’t provide complete information, Social Security may not get important medical records.  This could end up resulting in Social Security denying your claim. 

Non-medical evidence for SSDI:  Work History Report

Social Security requires information about your work history going back 15 years.  You should provide a clear description of each of your past jobs.  Social Security could deny your case if they don’t categorize your past work accurately.  Social Security can deny you for not returning the work history report forms. 

Non-medical evidence for SSDI:  Function Reports

Social Security needs to understand how your conditions impact your daily functioning.  Therefore, they send you a Function Report to complete.  This form asks you to describe how you perform normal daily activities.  It is important to describe any problems you have or any assistance you need for your daily activities. 

Medical Evidence for SSDI

Your medical evidence should include records only for the period of time that you became disabled and unable to work.  Your treatment should also be continuous and ongoing.  Medical evidence can include:

  • Firstly, Treatment notes and physical examinations
  • Secondly, Imaging such as MRIs, x-rays, CT scans or nerve testing
  • Thirdly, Blood work or biopsy results
  • Fourthly, Pulmonary tests
  • Lastly, Mental health records

Example 1: medical evidence for SSDI

For example, Kelly injured her neck in a car accident.  She required a cervical spinal fusion surgery.  Despite surgery, she continued to have severe pain and difficulty moving her neck.  She also still had problems using her hands due to numbness and tingling.  Kelly sees her doctors regularly for her symptoms.  Her records include x-rays, MRIs and nerve testing documenting her neck impairments.  Her doctors also continue to note limited range of motion and decreased sensation and strength in her arms and hands in their office notes.  Kelly provided proof through her medical records that her conditions caused a serious problem using her arms and hands.  As a result, Social Security approved Kelly’s claim. 

Medical evidence for SSDI from specialists

The type of treatment you receive can also impact your disability claim.  Often, records kept by specialists record your symptoms and problems better than a primary doctor.  They focus on specific information that Social Security needs to approve your disability benefits.  This can include special tests or examinations.  This can especially be true for any mental health impairments.  Generally, receiving medication from your primary doctor will not be enough to document your mental health conditions.  

Example 2:  medical evidence from specialists 

As an example, Julie suffers from anxiety and panic attacks.  Her panic attacks happen unexpectedly.  She receives medication from her psychiatrist.  She also sees a therapist regularly.  However, she still suffers from panic attacks many times during the day.  She has even had to go the emergency room during her panic attacks.  Her panic attacks make it hard for her to finish things she starts.  At times, her panic attacks keep her from leaving the house.  Social Security finds that Julie would miss work a lot due to her panic attacks.  Therefore, Julie qualifies for disability benefits. 

Medical evidence for SSDI and RFC forms

Residual functional capacity (RFC) forms can help support your disability claim.  RFC forms explain how your symptoms impact your ability to work.  An RFC form can include both mental and physical limitations. 

Physical RFC forms

A physical RFC form includes questions about your ability to do things like:

  • How long  you can sit, stand or walk at one time or in an 8 hour work day
  • How much weight you can lift or carry
  • If you need an assistive device such as a cane, walker, wheelchair or crutches
  • Using your arms and hands for activities such as reaching, pushing, pulling, gripping or grasping objects
  • If pain, fatigue, other symptoms or side effects from medications cause limitations with concentration, persistence or pace

Mental RFC forms

A mental RFC form includes questions about your ability to do things like:

  • Your ability to understand, remember or carry out instructions, interact with others such as supervisors, co-workers or the general public
  • Your ability to maintain attention and concentration
  • If your symptoms interfere with your ability to show up to work, arrive on time or have to leave early

Example 3:  medical evidence and RFC forms

For example, say you are under the age of 50 and worked before as a waitress.  You have a back injury that interferes with your ability to do this type of work.  You also have side effects from your medications that make you drowsy.  In an RFC form, your doctor states that you cannot sit for more than 3hours or stand or walk for more than 2 hours in a work day.  Your doctor also states that you have problems with attention and focus due to your medications.  These limitations help support your disability claim because it shows that you could not work a full 8 hour day. 

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What Are the Legal and Financial Requirements of SSDI?

What Are the Legal and Financial Requirements of SSDI?

What Are the Legal and Financial Requirements of SSDI? You can file for Social Security disability benefits (SSDI) if you are unable to work.  However, there are certain requirements that you must meet.  First, you must meet the non-medical requirements for SSDI.  Second, you must meet the medical requirements. 

To qualify for SSDI, you must have worked a certain number of years.  You must be between the ages of 18-65 years old.  You do not need to be a US citizen.  Any worker with a valid Social Security number who paid into Social Security may file for benefits.  Your medical conditions must keep you from being able to work for at least 12 months. 

Each year that you work and pay into Social Security, you earn work credits.  Generally need to earn 20 work credits to meet the requirements for SSDI.  However, if you are younger, you may meet the requirements for SSDI with fewer credits.  Additionally, you must have worked recently for SSDI.

Your date last insured (DLI) is the last date you can qualify for SSDI benefits.  Your coverage for SSDI ends after a certain amount of time from when you stopped working.  Generally, your DLI expires five years after you stop working.  However, your DLI may be within less than five years if your earnings were low or inconsistent.  You can still meet the requirements for SSDI if your DLI has expired.  You would need to prove that you meet the medical requirements for SSDI before your DLI. 

For example, say you stopped working in 2014.  As a result, your DLI would expire in 2019.  Therefore, you would need to show that your medical conditions kept you from working before 2019. 

Financial requirements for SSDI

As mentioned, SSDI requires that you earn a certain amount of work credits to qualify.  Therefore, there are no limits the amount of assets, cash or other resources you own.  Additionally, there aren’t any limits to the amount of unearned income you make.  There aren’t any limits to the amount of income your spouse makes either. 

Financial requirements for SSDI and unearned income

Social Security considers any money you receive outside of a job as unearned income.  Under SSDI, you can receive income from other sources and still qualify to receive benefits.  Examples of unearned income include:

  • Income from retirement accounts, dividends or stocks
  • Unemployment benefits
  • Rental income
  • Alimony or child support

Financial requirements for SSDI: substantial gainful activity

Since Social Security defines disability as the inability to work, if you are working, you may not qualify for SSDI.  Social Security considers work earnings over a certain amount “substantial gainful activity” or SGA.  If you earn over the SGA limit, you will not qualify for SSDI.  In 2020, earnings S1, 260 per month or (before taxes) are considered SGA.  If you are working part-time and earning less than SGA, you may still qualify for SSDI.  However, any work may make it harder for Social Security to approve your claim. 

Social Security disability requires that your medical conditions keep you from working at least 12 months.  Unlike workers’ compensation or veterans’ disability benefits, Social Security doesn’t offer partial disability.  You can qualify for SSDI:

  • If You meet strict requirements of a Social Security impairment listing
  • You fall under a medical-vocational allowance
  • Your medical conditions prevent you from working in any job at all

Social Security considers whether your medical conditions fall under their listing of impairments, known as the Blue Book.  Typically, the Blue Book requires that your medical conditions meet very specific requirements.  SSA reviews clinical findings and laboratory tests to determine if your disability meets the listing.  If you have not had the clinical or laboratory tests required in the listing, you should ask your doctor to perform them. 

Social Security uses a chart called the Medical-Vocational guidelines to evaluate your disability claim.  These guidelines are known as the “grid rules”.  The grid rules make it easier for people 50 or older to win their case.  Social Security understands that it may be harder for older people to do new or different work.  However, you must first show that you can’t do any past work.  Even if Social Security thinks you can do something else, you may still qualify for SSDI.  The rules are even more favorable if you are over 55. 

Applying the grid rules

The grid rules consider different factors.  These include your age, education, work background, work skills and your residual functional capacity (RFC.)  Your RFC is what you can do despite your medical conditions.  Once Social Security determines your RFC and work background, they will look to the grid rules.  There are separate charts for sedentary, light and medium physical categories.  For people over age 50, he more physically limited you are, the more likely the grids will show you should be found disabled. 

Example 2:  applying the grid rules over 55

For example, Andy, a 56 year old man previously worked as a janitor.  He could no longer work because he has severe arthritis in his shoulder.  He could no longer lift or carry up to 50 pounds.  Since Social Security found Andy could no longer do his past work, the grid rules allowed them to approve his disability case. 

Example 3:  applying the grid rules over 50

As another example, Barbara, a 53 year old cashier stopped working because she had severe arthritis in her knees.  She could no longer stand or walk for long periods.  Social Security found that she could not perform her past work as a cashier.  The grid rules allowed Social Security to approve her case, even though she could have done other types of work requiring less standing and walking. 

If your conditions don’t meet the listings and you don’t fall under the grid rules, you can still qualify for SSDI.  Social Security evaluates your medical records to determine your RFC.  You want to provide as much documentation and records as possible related to your medical conditions.  You should see your doctor consistently.  Your doctor can also provide an opinion to explain how your conditions impact your functioning.  If Social Security determines that your conditions keep you from working in any job, you would qualify for SSDI. 

Disability Help Group, Call Now for a Free Case Review, 800-700-0652

Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

How is Disability Amount Determined?

How is Disability Amount Determined?

How is Disability Amount Determined? Social Security bases your disability insurance benefits (SSDI) on the amount of earnings that you paid taxes on.  Therefore, everyone’s amount is different.  

How are benefits calculated?

Earnings you paid taxes on are called “covered earnings.”  Social Security calls your average covered earnings Average Indexed Monthly Earnings (AIME).   Social Security uses your AIME to figure your Primary Insurance Amount (PIA).  Your PIA determines the amount you would receive from Social Security.  Make sure your Disability Amount Determined is correct.

Average Indexed Monthly Earnings

Social Security adjusts or indexes your lifetime earnings to account for the increase in wages that happened during the years you worked.  Social Security uses up to 35 working years in their calculation.  First, they take the years with the highest indexed earnings and add them together.  Next, they divide them by the total number of months for those years.  Then, Social Security rounds down to reach your AIME which will be used to determine your disability amount. 

Determining AIME for your disability amount

If you don’t have 35 years work history, Social Security calculates your AIME a little differently.  Firstly, they will count the number of years between the time you turned 21 and the year you became disabled.  Secondly, they subtract one-fifth of that total number of years or five years, whichever is less. 

Your Social Security earnings statement

You can also check your estimated benefit amount on your Social Security benefits statement.  Generally, checking your statement is the easiest way to find out your disability amount, which you can do by logging on to Social Security’s website at www.ssa.gov/mystatement.  You would need to set up an account before accessing your statement.  Additionally, you can request your statement from Social Security. You want to make sure your disability amount determined is accurate.

Other disability payments can reduce your disability amount

Social Security will reduce your disability payments if you receive other disability benefits.  For example, these would include worker’s compensation benefits.  They might also include temporary state disability benefits.  Generally, you can’t receive more than 80% of the average amount you earned before you became disabled.  Therefore, if both your Social Security disability benefits and other disability payments are more than 80%, Social Security reduces your disability payments. 

Other disability payments that do not reduce your disability amount

Private long-term disability insurance benefits won’t reduce your Social Security disability amount. VA or SSI benefits won’t reduce your SSDI benefits either. You want to make sure your disability amount determined is accurate.

Disability back pay

Under SSDI, you can receive benefits back to the application date.  However, you can also qualify to receive retroactive benefits.  Social Security pays retroactive benefits for the months between when you became disabled and when you applied for benefits.  Additionally, these benefits can go back one year before the application filing date. Therefore it will be involved in determining your disability amount.

SSDI back pay and the 5 month waiting period

Social Security does not pay back pay for the first five months after your disability began.  This will determine your disability amount. You start receiving benefits at the beginning of the sixth month.  Typically, the 5 month wait period can be much shorter than the time it takes for Social Security to approve your application. 

Cost of living adjustment (COLA) and your disability amount

Each year, Social Security benefits may be increased to adjust to the increasing cost of living.  Generally the Consumer Price Index (CPI) determines any COLA amounts increases each year.  Therefore it will be involved in determining your disability amount.

Determining your disability amount for SSI

Unlike SSDI, SSI is a needs based program and doesn’t depend on your work history.  Therefore, SSI has a maximum monthly rate.  Firstly, the federal SSI payment standard for 2020 is $783 per month.  Secondly, most states provide an additional small supplemental payment.  Thirdly, Social Security calculates your SSI disability amount based on your income, assets and resources.  Fourthly, your SSI benefit can be reduced by wages you or your spouse earn and other resources you receive. You want to make sure your disability amount determined is accurate.

Disability Help Group, Call Now for a Free Case Review, 800-700-0652

Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

How Do I Appeal an SSDI Denial?

How Do I Appeal an SSDI Denial?

How Do I Appeal an SSDI Denial? Has Social Security denied your claim for SSDI benefits?  You may think filing a new claim can be better than appealing.  However, you should appeal any denials.  Re-filing can delay the appeals process.  Your chances for getting SSDI benefits improve when you appeal. 

Where do I appeal an SSDI denial?

You can file an appeal several ways.  First, you can appeal your denial online.  This can be the easiest way to appeal an unfavorable decision.  Second, you can file an appeal with your local Social Security office.  If you have a representative, they can help you file an appeal of your SSDI denial. 

How long do I have to file an appeal?

You have 60 days to appeal an SSDI denial.  Social Security gives you an extra 5 days to allow you to receive your denial in the mail.  Therefore, you have a total of 65 days from the date on your denial to appeal your SSDI claim.  If you don’t file within the 65 days, you may have to re-file your claim.  Social Security allows you to file an appeal in more than 65 days if you have good cause for missing your deadline.

What is good cause to appeal an SSDI denial for missing your appeal deadline?

Good cause can include several reasons.  Social Security considers:

  • What circumstances kept you from making the request on time;
  • Social Security’s action misled you
  • Whether you didn’t understand what you needed to do to appeal
  • Whether you had any physical, mental, education or language limitations that prevented you from appealing on time

Examples of good cause for missing your deadline

  • You were very sick when the appeal was due and couldn’t have contacted Social Security yourself or through someone else.  You would need proof that you were seriously ill.
  • There was a death or serious illness in your family
  • Records needed for your appeal were destroyed by an accident or fire.
  • You never received your denial notice
  • Some other type of unusual or unavoidable circumstances and you could not reasonably be expected to have met the deadline

What information should I include in my appeal for SSDI denial?

Most importantly, you need to include updated treatment information on your appeal.  You should tell Social Security about all the doctors you’ve seen since filing your application.  You should include any emergency room visits, also include any hospitalizations.  On appeal, Social Security looks at any new or missing information that might change their minds. 

Why was my SSDI claim denied?

Many people receive a denial for SSDI benefits the first time they apply. Understanding why Social Security denied your claim can help increase your chances on appeal.  Specifically, you will know what your claim was missing or where your claim can be improved.  Common reasons include:

  • Lack of medical evidence
  • You are working
  • Not following your doctor’s orders
  • Ignoring requests

SSDI denials for lack of medical evidence

Frequently, Social Security denies claims because there was not enough medical proof to show your condition keeps you from working.  You must show that your symptoms cause serious problems in your functioning.  Therefore, you should see your doctors regularly.  Additionally, you should see specialists for your conditions.  Often, specialists keep better records about your symptoms and problems better than a general doctor.  They focus on specific information Social Security needs to approve your SSDI benefits. You need to Appeal your SSDI Denial on time or you will have to start over.

SSDI denials for working  

Social Security defines disability as the inability to work for at least 12 months.  Therefore, if you are working, you may not qualify for SSDI benefits.  Social Security considers earnings over a certain amount “substantial gainful activity” or SGA.  If you earn over the SGA limit, you won’t qualify for SSDI.  If you have not been out of work for at least 12 months, you won’t qualify for SSDI. 

SSDI denials for not following your doctor’s orders

If you don’t follow your doctor’s recommendations, Social Security could deny your case.  Your doctor’s treatment plan shows that you cannot work due to your condition.  Without a treatment plan, Social Security can have trouble establishing that your condition impacts your work ability.  This also includes taking prescribed medications correctly.  Additionally, when you don’t follow your doctor’s orders, Social Security can decide that your limitations would be less serious if you followed their recommendations.  This can result in an SSDI denial. You need to Appeal your SSDI Denial on time or you will have to start over.

SSDI denials for ignoring requests

Often, Social Security requires additional information to process your SSDI claim.  This may include more information about your treatment or work history.  Social Security may not be able to make a decision without this information.  When you don’t respond to their requests, Social Security denies your claim for failure to cooperate. 

Get help appealing your SSDI denial

If you’ve been denied for SSDI benefits, you should consider working with a disability advocate.  Hiring a disability advocate can significantly increase your chances of winning.  A disability advocate makes sure you don’t miss any deadlines for appealing.  They can help get your claim on the right track for winning your claim. 

Disability Help Group, Call Now for a Free Case Review, 800-700-0652

Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

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Who Qualifies for Social Security Disability?

Who Qualifies for Social Security Disability?

You can qualify for Social Security disability if you have a medical impairment or combination of medical impairments that keep you from working.  Your conditions must keep you from working for at least 12 months.  Social Security offers two types of disability benefits.  These include Social Security disability insurance benefits and Supplemental Security Income benefits.

Qualifying for Social Security Disability Insurance Benefits

To qualify for Social Security disability insurance benefits (SSDI), you must have worked a certain number of years.  Additionally, you must be between the ages of 18 and 65 years old.  You do not need to be a US citizen to qualify for SSDI.  Any worker with a valid Social Security number who paid into Social Security may file for benefits. 

Qualifying for Social Security Disability and Work Credits

You receive work credits each year that you work and pay taxes.  Generally, you need to earn a total of 20 work credits to qualify for SSDI benefits.  However, your work needs to have done recently.  Like other insurance programs, your coverage ends after a certain amount of time from when you stop working.  Unfortunately, if you stopped working more than five years before filing, you may not currently qualify for Social Security disability insurance benefits. 

Qualifying for Social Security Disability and Your Date Last Insured

Your date last insured (DLI) is the last date you can qualify for SSDI benefits.  Your DLI depends on when you last worked.  Typically, your DLI expires five years after you stop working.  However, if your earnings were low or inconsistent, your DLI may be less than five years.   For example, if you stopped working in 2020, your DLI would expire in 2025. 

Qualifying for Social Security Disability with an Expired Date Last Insured

  1. You may still qualify for SSDI benefits even if your DLI has expired. 
  2. Show your disability began before your DLI expired. 
  3. Medical evidence that shows you couldn’t work before your DLI. 

Example 1:  qualifying for Social Security disability with an expired DLI

As an example, Susan stopped working in 2012 when her lupus symptoms interfered with her ability to work.  As a result, her DLI expired in 2017.  Susan would need to show that her lupus symptoms prevented her from working before 2017. 

Qualifying for Social Security Disability:  Dependent Spouses and Children

Under SSDI, a disabled individual’s spouse and dependent children can receive partial dependent benefits.  Social Security pays benefits in addition to the disabled individual, called auxiliary benefits.  Spouses may qualify for additional benefits if they have a child under the age of 16.  They may also qualify if they are at least 62 years old.  Children may qualify if they are:

  • Under age 18
  • A disabled adult before the age of 22
  • A high school student under the age of 19

Qualifying for Supplemental Security Income Benefits

Unlike SSDI, you do not need to earn any work credits to file for Supplemental Security Income (SSI) benefits.  Social Security bases SSI eligibility on your income, assets and resources.  Additionally, both adults and children can file for SSI benefits.  For children, Social Security considers their parents’ income, assets and resources.  Dependent children or spouses do not receive payments under SSI. 

Income Guidelines to Qualify for SSI Disability Benefits

SSI benefits are considered a “means-tested” benefit.  Therefore, you must meet certain income guidelines to file.  To meet the SSI income requirements,

  • You must have less than $2,000 in assets (or $3,000 for a couple)
  • Have a very limited income
  • Are a US citizen (there are very few exceptions to this)

Example 2:  qualifying for SSI

For example, David hasn’t worked in many years.  He recently was in a car accident.  He suffered from a very serious back injury.  David lived with his parents and received food stamps.  He did not have any money in his bank account.  Since David had very little income and resources, he was able to file for SSI.  

Qualifying for SSDI and SSI

Sometimes, you can file for both SSDI and SSI benefits at the same time.  You earned enough work credits for SSDI.  You also meet the financial requirements for SSI.  Commonly, Social Security calls this “concurrent benefits.” 

Example 2:  qualifying for SSDI and SSI

For example, Janet worked consistently in the past.  However, she had to stop working due to her medical conditions.  Now that she is no longer working, she doesn’t have any income.  Janet applied for state assistance or relies on others for financial help.  Janet can file for SSDI because of her work history.  Additionally, she can file for SSI because she now has a limited income. 

Medically Qualifying for Social Security Disability Benefits

Social Security also looks at your medical conditions.  Social Security considers whether your medical conditions fall under their listing of impairments, known as the Blue Book.  Typically, the Blue Book requires that your medical conditions meet very specific requirements.  If your condition doesn’t fall under the listings, Social Security will look at what you can still do despite your impairments.  Social Security calls this your residual functional capacity.  If Social Security determines that your medical conditions keep you from working, they will approve your disability benefits. 

Working With a Disability Advocate

Hiring an experienced disability advocate greatly improves your chances of getting approved.  A disability advocate will explain both the medical and non-medical rules for qualifying for disability benefits.  They can help you file applications and appeals.  Most importantly, they prepare you for a hearing if that becomes necessary.  Specifically, your disability advocate reviews your file.  They also make sure all the necessary medical evidence has been submitted. 

Disability Help Group, Call Now for a Free Case Review, 800-700-0652

Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

What is a Disabling Condition?

What is a Disabling Condition?

What is a Disabling Condition? Social Security considers any medical condition disabling if it keeps your form working.  However, your conditions also must keep you from working for 12 months or longer.  Social Security has a list of specific conditions that will automatically qualify you for benefits, known as the “Blue Book.” 

Disabling Conditions Under the “Blue Book”

The Blue Book lists different medical conditions that qualify for disability benefits.  However, you must meet certain conditions.  Generally, the requirements under the Blue Book describe the most severe cases of any condition.  The Blue Book generally categorizes conditions by body system or function.  Although there is a separate disability listings for adults and children under the age of 18.  Above all they also include a listing for growth impairments. 

Listing of Medical Impairments

For adults, medical conditions that qualify for disability benefits include:

  • Musculoskeletal system, special senses and speech, respiratory disorders , cardiovascular disorders
  • Digestive system disorders, genitourinary disorders, hematological disorders, skin disorders
  • Endocrine disorders, congenital disorders affecting multiple body systems, neurological disorders, mental disorders, cancer and immune system disorders

Getting Disability on a Diagnosis Alone

Social Security has very few conditions that qualify you for benefits on a diagnosis alone.  These include ALS, an organ transplant and certain cancers.  Not all cancers will automatically qualify your for benefits. 

How do you Meet a Listing Level Impairment?

The Listings of Impairments set out the requirements for how severe the symptoms must be to qualify you for disability benefits.First, your doctor must diagnose you with a disability found under the listings. Second, Social Security needs to review your medical records.  They look at your doctors’ treatment notes and test results.  If you haven’t had the clinical or laboratory tests required in the listing, you should ask your doctor to perform them. 

Example 1: when your disabling condition meets a listing

For example, Donna has degenerative disc disease and herniated discs in her lower back.  Donna requires a walker for standing and walking.  She has an MRI documenting both the degenerative disc disease and herniated discs.  Her treatment records show that she has limited motion in her lower back.  She also has muscle weakness, decreased sensation and positive straight-leg raise testing.  Her doctors have continued to document these problems in her records.  Donna meets the listing under 1.04 for disorders of the spine. 

Disabling conditions and medical equivalence

If you do not meet the specific requirements under the Listings, you can medically equal them.  Social Security understands that there are many ways to diagnose and document the same illness.  Your disability may “equal’ a listing if it does not quite meet all of the requirements under the listing.  For example, the listing may require a specific result on a specific lab test.  However, you were given a different test that showed the same results.  SSA may find that your disability equals the listing.  Medical equivalence can be found if:

  • Your medical impairment is at least equal in severity and duration
  • But does not quite match the requirements under the listing.  

What if your Disabling Condition isn’t in the Listings?

You can still be found disabled if your disability isn’t found in the listings.  Social Security can still find you disabled if you can show that your conditions keep you from working.  Some examples of other disabling conditions include: Carpal Tunnel Syndrome; Fibromyalgia; Chronic Regional Pain Syndrome; Reflex sympathetic dystrophy; or Celiac Disease.

What if your Disabling Condition Doesn’t Meet or Equal the Listings?

If your disabling condition doesn’t meet the listings, Social Security considers your residual functional capacity or RFC.  Your RFC is what you are able to do despite your medical conditions.  An RFC includes both physical and mental limitations.  Social Security looks at your medical evidence to determine your RFC.  They will also consider RFC forms that are filled out by your doctors.  

What Medical Evidence is Considered?

Medical evidence for the period of time that you became disabled and unable to work will be used to determine if you are disabled, it is helpful if your treatment is continuous and ongoing.  Firstly, medical evidence can include your treatment notes and physical examinations. Secondly, imaging such as MRIs, x-rays, CT scans or nerve testing. Thirdly, blood work or biopsy results. And, lastly, pulmonary tests or mental health records.

Disabling conditions and your Age

Social Security has special disability rules the older you are.  If you are over 50 years old call us immediately to see if you qualify as an older individual. The older you are, the easier it can be to win your case. 

Example 2:  Applying the Grid Rules

For example, Justin, a 57 year old man previously worked as a painter.  He needs a cane, applied for disability because he injured his knee, trouble in standing and walking.  His medical records include MRIs and x-rays of his knee documenting his injury.  His doctors have also documented that he has pain and limited motion of his knee.  Since he is over the age of 55, the grid rules allow Social Security to approve his claim. 

 Contact us now for a free consultation.

Disability Help Group, Call Now for a Free Case Review, 800-700-0652

Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

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