Qualifications to Receive Disability

A disability can turn your entire life upside down physically, emotionally, and financially. While Social Security Disability Insurance (SSDI) can provide financial help for disabled individuals, applications are complex and frequently denied. Various medical conditions and disabilities can be reasons to get disability benefits. However, applicants may have to go through an appeal process to get the financial help they deserve. 

Working with a lawyer before your first application for benefits could help to prevent a denial. Our attorneys can ensure that your application is free of mistakes and accompanied by the required medical evidence and other supporting documents. If you had a disability claim denied, having an attorney in your corner can be crucial. 

Morgan & Morgan’s motivated disability attorneys know how to handle disability claims and fight denials tirelessly. Get started with getting what you deserve today. Contact us for a free case review to find out how we can help.

What Is Social Security Disability Insurance?

If you or a loved one becomes permanently disabled, SSDI can provide an essential lifeline with disability payments. However, to qualify, individuals must have worked a certain period of time and collected work credits before they became disabled. Applicants must also prove that they have a condition providing them with a reason to get disability benefits as per the SSDI definition. 

The amount of SSDI benefits you could receive will depend on your average covered lifetime earnings before your disability. The average monthly amount disabled workers received in 2020 amounted to $1,277, according to the SSA. In some cases, a spouse or dependent children could also be eligible for certain benefits under the program. 

What Are the Main Reasons for Getting Disability Benefits?

You could be entitled to SSDI benefits, if:

• You have a significant mental or physical impairment
• Your condition prevents you from working at your job
• You are unable to take up alternative work due to the disability
• Your disability is expected to last at least a year or until death

Reasons You May Not Qualify for Benefits

Individuals with a debilitating medical condition or disability that makes working difficult may wonder whether they could receive disability benefits. However, you are unlikely to be successful with a claim if:

• A medical professional believes your condition does not prevent you from working
• Your disability or condition is temporary
• You have not accrued enough work time to qualify for SSDI benefits
• You are working and earning more than $1,310 a month

It is also important to note that those applying for SSDI are generally unable to work while waiting for a decision. It can take more than a year to find out whether a claim is successful in some cases. If your chances to recover SSDI benefits are low, being without an income for a year or longer may simply not be worth the risk. However, you do not have to decide whether to apply for disability on your own. A disability lawyer can help clarify your options.

Reasons for Disability Claim Denials

Each year, the Social Security Administration (SSA) rejects more than half of all first claims for disability benefits. While each claim is unique, there are some common reasons why claims are denied. Some of the main reasons for denial of disability benefits can include:

Insufficient Medical Evidence

Claims typically get denied if there is a lack of comprehensive medical evidence showing the extent of the disability. An applicant should supply strong medical proof of their disability and describe why the condition leaves them unable to work. 

Failure to Follow Treatments

Failure to follow treatment advice can disqualify an individual from receiving disability benefits. If you do not follow your doctor’s treatment plan diligently, your application could be denied. 

Previous Claim Denials

When a claimant receives a denial notice, they must go through a specific appeals process. If an individual simply files another application for benefits instead of appealing, their application is usually denied again.

Earning too Much

SSDI benefits are designed to help disabled individuals who cannot work. Therefore, if an applicant is working and earning a wage, they are generally ineligible for disability payments. There are some instances where individuals can collect disability benefits while earning a limited amount of income. However, being able to work usually disqualifies an applicant from receiving SSDI benefits. 

Failure to Cooperate

If the SSA requests additional supporting information from an applicant, and they fail to supply the documents or refuse to cooperate, a claim will generally be unsuccessful. 

Receiving a denial letter can be disappointing and upsetting. However, do not despair if your claim was denied in the first instance, as this is relatively common. You can appeal against the decision and still potentially receive disability benefits. A tenacious Social Security Disability attorney can get your paperwork in order and prepare you for the appeals process and any relevant hearings. 

Conditions That Can Qualify an Individual for Disability Benefits

Details of conditions that could qualify for disability benefits are listed in the Code of Federal Regulations (CFR), Appendix 1 to Subpart P of Part 404 and can include but are not limited to:

• Conditions of the musculoskeletal system
• Amputations 
• Deformities
• Impaired senses such as hearing or sight disabilities
• Respiratory illnesses such as asthma or COPD
• Cardiovascular illnesses
• Digestive system disorders
• Chronic kidney disease
• Blood disorders
• Significant skin disorders 
• Diabetes
• Thyroid disorders
• Mental health conditions 
• Cancer
• Immune system disorders 

The SSA’s list of qualifying disorders, also called the “Blue Book,” is not exhaustive. The agency will consider a number of other factors when arriving at a decision, such as past work experience, age, education, the severity of medical conditions, and others. Individuals can still qualify even if their condition is not listed in the Blue Book. 

However, to qualify for benefits, your condition must limit your ability to earn a living similarly to the disorders listed in the Blue Book. An attorney from our firm can work tirelessly to present your case to the SSA in the strongest possible terms.

The Evaluation Process for Receiving Disability

Many SSDI applications are denied in the first instance and have to go through one or several appeal stages. Since the screening process developed by the SSA is comprehensive, knowing what to expect when applying for disability benefits can be helpful.

Establishing Severity of the Disability

Individuals will not have enough of a reason to get disability if the SSA does not consider them permanently disabled. The agency will assess whether your condition is serious enough to prevent you from working. If the SSA determines that your disability qualifies, you will be eligible for benefits, provided you submit the necessary supporting medical evidence.  

Determining Ability to Work

If your condition is not listed in the SSA’s Blue Book, you could still receive disability benefits. However, in the first instance, the SSA will want to establish whether you could still work in your previous job. If you are unable to, the agency will assess whether you could carry out another type of employment. If you could potentially adapt to other employment, your claim will most likely be denied. 

You Could Get a Second Opinion

If your disability is not listed in the Blue Book, your disability claim predominantly hinges on your doctor’s cooperation. Applicants for benefits may have to complete a "Residual Functional Capacity" (RFC) assessment that includes statements from your doctor regarding what you can and cannot do due to your condition. 

While a doctor does not decide whether you qualify for disability, their cooperation will be crucial for a successful claim. If a doctor’s opinion leaves you unable to apply for SSDI, you could get a second opinion from a different medical professional. A Social Security Disability lawyer can help you with the process of getting a second opinion.