How Social Security Disability Is Decided

If you experience an illness or medical condition that prevents you from being able to work, you can apply for Social Security Disability (SSD) coverage. SSD is a type of insurance provided by the government to those who can’t continue working because of an injury, illness, or medical condition.

However, specific criteria determine how Social Security Disability is decided for each applicant. Therefore, understanding each criterion is essential when you file your application. Any mistake or misunderstanding of the information you need to provide can jeopardize the decision-making process for your SSD application. Our lawyers explain further. 

Understanding How Social Security Disability Gets Decided

Each Social Security Disability application is sent to and initially processed by the Social Security Administration (SSA). In addition, the SSA has local offices as well as state agencies called Disability Determination Services (DDS). 

If an applicant is denied and appeals it, those are reviewed and determined by either an administrative law judge or a DDS. Once the application is received, the SSA asks a series of five questions when deciding if you qualify for SSD.

1. Are You Currently Working?

First, the SSA will look to see if you are working in the current year. If you are indeed employed and making more than an average of $1,220 per month, your application usually gets denied.

If the SSA determines you are not currently working, they will send your application on to the DDS to handle steps 2-5 in evaluating your medical condition.

2. Is Your Condition Considered “Severe?”

The DDS will look at the condition that has kept you from working. This medical condition must have greatly limited you from performing basic actions like standing, sitting, lifting, walking, and remembering for at least 12 months. If you do not meet these criteria, the DDS will not consider you disabled. But if you do, they will proceed to the next step.

3. If Your Condition Listed as a Disabling Condition?

The SSA maintains an official List of Disabling Conditions they reference during this step. If your medical condition is on this list, it has been considered severe enough to keep someone from performing “substantial gainful activity.”

There are also certain conditions that can qualify someone for disability as soon as they’re diagnosed. These are known as “compassionate allowances” and include conditions like Lou Gehrig’s disease (ALS), acute leukemia, rare childhood diseases, and adult brain disorders. 

Other serious conditions can go through a fast-track process known as the Quick Disability Determinations where granting disability gets decided faster than usual. For example, if the condition that disables you from working does not appear on the medical conditions list, your application moves to the next step.

4. Are You Able to Perform Past Work?

The SSA now determines whether they think your condition prevents you from performing any past work you used to do. If they decide you can still complete work, your application will get denied. If they determine you can’t do past work, the process moves to the last step.

5. Can You Perform Another Type of Work?

If the SSA agrees you can’t perform work at your most recent job or past work, they will look to see if there’s any other type of work you can perform with your condition. Factors beyond your condition are considered here, including your age, education level, and job skills. 

If you can still complete other types of work, your application will get denied. But if it gets determined you can’t do any other kind of work, it’s then decided that you qualify for SSD.

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Other Situations that May Qualify for SSD

There are certain rare situations where Social Security Disability is decided based on criteria beyond the above mentioned ones. Those include:

• Being blind or having low vision
• Disabled children
• Workers’ widowers or widows
• Wounded veterans and warriors

Each of these follows different rules in terms of how benefits get awarded. If you follow into any of these categories, talk to your Social Security Disability lawyer or local SSA office for eligibility details that apply to you.

Why SSD Applications Get Denied

Most workers in the United States have paid into Social Security Disability their entire lives. The purpose of SSD is to assist those who need help paying bills and supporting themselves and their families because of their disabilities. 

Unfortunately, 70% of SSD claims get denied for various reasons. You may be denied for: 

• Not following the instructions on the application 
• Not providing enough information or evidence to support your disability claim
• Too many past rejections or appeals 
• Your case being insufficient for the SSA 

We can’t list every reason as to why SSD applications get denied. However, know that you have many options available to you that can still benefit you. Remember, don’t feel like you don’t deserve them. After contributing to Social Security all your working life, you should always fight hard to receive them once you’re unable to work. 

What to Do If Your Social Security Disability Application Gets Denied

If you received a denial of Social Security Disability benefits, don’t give up hope. Unfortunately, we find many denied applications result from a lack of documentation or not enough information to back up the claim. However, just because you get denied doesn’t mean you don’t deserve to receive benefits or have lost your chance. You can appeal, and we can help.

Get Help from an Experienced Lawyer 

While hiring a lawyer isn’t strictly necessary in every SSD case, that doesn’t mean that you shouldn’t at least speak to one for further assistance, especially if you’re having trouble getting your application approved or don’t know where to start. Our lawyers will assist you every step of the way and ensure that you get the process right the first time.

We don’t engage in any predatory practices. Our primary goal, first and foremost, is to ensure that you get the benefits you deserve. We don’t charge any fees upfront, and our client testimonials show our dedication to our clients. 

Talk to Our Social Security Disability Lawyers Today

Whether you’ve been denied or need help with your first Social Security Disability application, John Foy & Associates can assist you in the process. We’ve been helping SSD applicants for more than 20 years, and we understand how the system works. 

We’d love to give you a free consultation to talk about the details. To schedule a free consultation today, call us or fill out our online contact form. There is no risk or obligation when you reach out to us. We are available 24/7.