When life takes an unexpected turn and a disability prevents you from working, financial stability can seem out of reach. Social Security Disability Insurance and Supplemental Security Income provide a safety net for those unable to work due to significant medical conditions. However, navigating the Social Security Administration’s complex system can be daunting and frustrating. That is where we come in.
At Abdi & Associates, an experienced Social Security Disability lawyer will be dedicated to helping you secure the benefits you need and deserve. Whether you are applying for the first time or appealing a denial, we provide personalized legal assistance every step of the way.
Understanding Social Security Disability Benefits
Social Security Disability benefits fall under two main programs:
- Social Security Disability Insurance (SSDI): This program is designed for individuals who have worked and paid Social Security taxes but now cannot work due to a disability. Eligibility depends on your work history and the severity of your medical condition.
- Supplemental Security Income (SSI): This program provides financial assistance to disabled individuals with limited income and resources, regardless of work history.
While both programs aim to support those with disabilities, their eligibility requirements and processes differ significantly. Our attorneys have knowledge of both SSDI and SSI, ensuring you understand which program applies to your situation.
Who Qualifies for Social Security Disability Benefits?
To qualify for SSDI or SSI, you must meet the Social Security Administration’s (SSA) strict definition of disability. This means:
- Work credits: You must have accumulated enough work credits by paying into Social Security through prior employment to be insured under the Social Security program.
- A medically determinable impairment: Your condition must be supported by medical evidence, such as physician diagnoses, lab tests, or imaging studies.
- Inability to perform substantial gainful activity (SGA): Your disability must prevent you from earning more than the SGA threshold, which is updated annually.
- Expected duration: Your condition must be expected to last at least 12 months or result in death.
Additionally, SSDI applicants must have sufficient work credits, while SSI applicants must meet stringent financial criteria. Understanding these requirements is critical to building a strong case. Our Social Security Disability attorneys will thoroughly evaluate your situation, gather necessary documentation, and present a compelling application to improve your chances of approval.
Common Conditions That Qualify for Disability Benefits
Many physical and mental health conditions can qualify for SSDI or SSI, provided they meet the SSA’s criteria. These may include:
Physical Disabilities
- Musculoskeletal disorders, such as herniated discs or arthritis
- Cardiovascular conditions, such as heart disease or hypertension
- Respiratory disorders, such as COPD or asthma
- Digestive disorders, such as Crohn’s disease or ulcerative colitis
- Endocrine disorders, such as diabetes or thyroid disorders
- Neurological disorders, such as multiple sclerosis or epilepsy
- Immune system disorders, such as lupus or HIV/AIDS
Mental Health Disorders
- Depression and anxiety disorders
- Post-traumatic stress disorder (PTSD)
- Bipolar disorder
- Schizophrenia
- Panic disorder
Chronic Illnesses
- Cancer
- Diabetes with complications
- Kidney disease requiring dialysis
Other Impairments
- Intellectual disabilities
- Autism spectrum disorder
If the SSA does not explicitly list your condition, you may still qualify if you can demonstrate that your condition is equivalent in severity to a listed condition. This requires detailed medical records and supporting evidence to prove your inability to work.
The Social Security Disability Application Process
Applying for disability benefits involves multiple steps. These include:
- Initial application: You will need to submit detailed information about your medical condition, work history, and limitations and provide supporting medical documentation.
- Medical review: The SSA will review your medical records to determine if your condition meets the criteria for disability.
- Disability determination: If the SSA approves your claim, you will begin receiving benefits. If it denies it, you can appeal the decision.
Appealing a Denial
If the SSA denies your SSDI claim, you can appeal the decision. The appeals process involves several levels:
- Reconsideration: This is the first level of appeal. The SSA will re-evaluate your claim and consider any new evidence you provide.
- Hearing: If the SSA denies your claim at the reconsideration stage, you can request a hearing before an administrative law judge (ALJ).
- Appeals Council review: If an ALJ denies your claim at the hearing stage, you can appeal to the Appeals Council.
- Federal court review: If the Appeals Council denies your claim, you can file a lawsuit in federal court.
Each step of the process has strict deadlines and requirements. Our Social Security Disability lawyers will handle every detail, ensuring your case is presented effectively at every stage.
Common Reasons for Denial
Applying for SSDI or SSI benefits can be complex and challenging. Unfortunately, the SSA denies many claims during the initial application phase. Understanding the common reasons for denial can help you avoid mistakes and strengthen your claim. Here are the most common reasons the SSA denies disability claims:
- Insufficient medical evidence: If your records are incomplete, outdated, or do not clearly describe the severity of your limitations, the SSA may deny your claim.
- Earning too much income: If you earn above the SSA’s SGA threshold, it will likely deny your claim, regardless of your medical condition.
- Failure to follow prescribed treatment: The SSA assumes your condition might improve if you follow prescribed treatments, making you capable of returning to work.
- Lack of a clear diagnosis: The SSA needs a clear, medically recognized diagnosis to evaluate your condition against their standards. Vague symptoms without a clear diagnosis are not sufficient.
- Failure to prove long-term disability: Short-term conditions or injuries, even if severe, do not meet the SSA’s duration requirement.
- Not meeting the SSA’s definition of disability: If your condition does not match or equal one of the impairments listed by the SSA, it may deny your claim.
- Failure to cooperate with the SSA: The SSA may deny your claim if it cannot obtain the necessary information to evaluate your case.
- Lack of work credits: If you do not have enough work credits based on your age and work history, you may be ineligible for SSDI.
- Returning to work too soon: The SSA may interpret work activity as evidence that your condition is not as limiting as claimed.
- Incomplete or incorrect application: Missing information, inconsistent answers, or incomplete forms make it difficult for the SSA to process your claim.
- Alcohol or drug use: If alcohol or drug use contributes to your disability, the SSA may deny your claim. The SSA requires that your disability would persist even without substance use.
- Failure to appeal after a denial: Many applicants fail to appeal after receiving an initial denial, assuming they will not qualify. Denials can discourage applicants, but many successful claims are approved during the appeals process.
Our team understands these pitfalls and works proactively to address them. By carefully preparing your application and providing robust medical evidence, we aim to minimize the risk of denial and expedite the approval process.
Tips for a Successful SSDI Claim
Here are some practical tips for submitting a successful SSDI claim:
- Understand the eligibility requirements: Ensure you meet the basic SSDI criteria before applying.
- Get a comprehensive medical diagnosis: Detailed medical evidence is the backbone of any successful SSDI claim. Work with your healthcare provider to obtain a clear diagnosis of your condition, keep detailed records of symptoms, treatments, and limitations, and ensure your doctor explicitly states how your condition limits your ability to work.
- Follow all prescribed treatments: The SSA wants to see that you are actively addressing your medical condition. Failing to follow prescribed treatments without a valid reason can lead to denial. If you cannot follow a treatment for medical or financial reasons, document those challenges.
- Be thorough and accurate in your application: When completing the SSDI application, provide complete and accurate details about your medical history, employment history, and daily living challenges, avoid overstating or understating your limitations, and double-check all forms for errors or omissions before submission.
- Maintain complete medical records: Visit your healthcare provider regularly to document the progression of your condition. Include all relevant diagnostic tests in your application, and request detailed, written opinions from your doctors about your ability to work.
- Communicate work limitations clearly: Explain how your condition impacts your ability to perform tasks associated with your job or other employment. Be specific about challenges with lifting, sitting, or standing for extended periods, concentrating or focusing due to pain or fatigue, and meeting deadlines or maintaining a consistent work schedule.
- Do not wait to apply: Apply for SSDI benefits as soon as you know your disability will last 12 months or longer. Delaying could result in the loss of work credits or create financial strain.
- Be honest about your situation: Exaggerating symptoms or misrepresenting your abilities can harm your credibility. Be honest and provide clear, consistent answers throughout the process.
- Stay organized: Keep a folder with medical records and test results, doctor’s notes and treatment plans, employer records, a detailed work history, and copies of all correspondence with the SSA.
- Be prepared for denials and appeals: If the SSA denies your initial claim, review the denial letter carefully to understand the reasons, file a timely appeal within 60 days of the denial, and provide additional evidence to strengthen your case during reconsideration or at a hearing.
- Consider using a daily symptom diary: Maintain a journal documenting how your condition affects your daily activities and quality of life. Include specific symptoms experienced each day, difficulties with routine activities like cooking, cleaning, or driving, and how your condition impacts your mental health.
- Seek professional legal help: Our experienced Security Disability lawyers at Abdi & Associates can help you navigate the complex SSDI process, ensure your application is complete and accurate, represent you in appeals and hearings if the SSA denies your claim, and maximize your chances of success by presenting a strong, evidence-backed case.
Why You Need Social Security Disability Attorney
Navigating the complex Social Security Disability process can be daunting. The system is intricate, and the stakes are high. That is where our skilled Social Security Disability lawyers come in. Here is why you should consider retaining us:
Increased Chances of Approval
- Proficient guidance: Our seasoned attorneys understand the nuances of SSDI law and can guide you through the process, ensuring you meet all requirements.
- Strategic filing: We can help you file your claim strategically, maximizing your chances of approval.
- Stronger case presentation: By effectively organizing and presenting medical evidence, we can build a compelling case that supports your disability claim.
Efficient Handling of Paperwork and Deadlines
- Timely submissions: We will meticulously handle all necessary paperwork, ensuring timely submission to avoid delays.
- Attention to detail: We will pay close attention to every detail, reducing the risk of errors that could jeopardize your claim.
Representation at Hearings
- Effective advocacy: If the SSA denies your claim, we will represent you at hearings and argue your case persuasively.
- Cross-examination skills: We can effectively cross-examine medical experts and other witnesses to strengthen your position.
Appeals Process Knowledge
- Strategic approach: If the SSA denies your initial, we can file timely appeals and build a strong case for reconsideration.
- Knowledge of regulations: We are well-versed in the complex appeals process and can navigate it efficiently.
Reduced Stress and Anxiety
- Peace of mind: Entrusting your case to our experienced Social Security Disability law firm can alleviate stress and allow you to focus on your health.
- Professional support: We will provide guidance and support throughout the entire process.
Do not let a denied claim discourage you. If the SSA has denied you SSDI benefits, it is crucial to seek legal help. Our experienced Social Security Disability attorneys can help you appeal the decision and fight for the benefits you deserve.
Take the First Step Today
If you are struggling with a disability and need assistance obtaining SSDI or SSI benefits, do not face the system alone. Let our Social Security Disability lawyers guide you through the process and advocate for your rights. Contact Abdi & Associates today for a free consultation. We will create a plan to help you move forward with confidence and peace of mind.