Every year, we offer free case evaluations to hundreds of people in North Carolina seeking Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. Unfortunately, no one cannot guarantee a positive result. Sometimes, even if you work with a good disability lawyer your claim may not be successful. But there are some factors that could work in your favor and help you win a claim for SSDI or SSI benefits.
First, let’s review the Social Security definition of disabled. The Social Security Program’s definition is, “any condition that is severe enough to prevent you from working for 12 months or more may be considered a qualifying disability.” For more information about what conditions qualify for disability you can read our blog post.
Now, let’s look at two signs that you may have a stronger-than-average claim. The first is your age.
Your age, and how it can affect your disability insurance claim
People who are older than 50 are defined by Social Security as being “of advanced age.” This means that they fall into a different category and may have a better chance of qualifying as physically disabled. Why?
The Social Security Administration uses grid rules to guide their claims process. These SSA grid rules are complex. The grids fall into four categories:
- Maximum sustained work capability limited to sedentary work as a result of severe medically determinable impairment(s)
- Maximum sustained work capability limited to light work as a result of severe medically determinable impairment(s).
- Maximum sustained work capability limited to medium work as a result of severe medically determinable impairment(s).
- Maximum sustained work capability limited to heavy work (or very heavy work) as a result of severe medically determinable impairment(s).
If you are found to be severely medically impaired, Social Security will use one of these grids to determine whether you are disabled or not. The grid rules take many factors into play including your age, your education level and your previous work experience.
If you can still do sedentary work, the SSA uses the grid for people who are limited to sedentary work. If you can still do light work, the SSA uses the grid for people who are limited to light work. And so on for the grids that designed to be used for medium or heavy (or very heavy work).
This is where age comes into play. When you look at the grids, you’ll note that claimants who are 50 or older are considered to be of ‘advanced age.’ These claimants can qualify for disability under less restrictive work limits.
Starting at 50 years old and if you meet all the conditions in the grid rules, SSA considers you disabled even if you can still do some sedentary work. At 55, those restrictions become even less strict, and SSA can rule you disabled even if you can still perform some light work.
In both those cases, SSA always assumes you can’t do your past relevant work first and you have to prove that you are severely medically impaired. There are also other limits and rules in place around working. You can learn more about working part-time on disability by reading our blog post.
That brings us to the second sign that you may have a better-than-average claim: medical evidence.
Medical Evidence to Support your Disability Claim
If you were building a house, you’d need a good foundation. The same is true for a social security disability claim. If you are applying for disability, you need a foundation of good medical evidence. Medical evidence usually falls into two categories: medical records and statements of support.
Social Security uses a step-by-step process with five questions to determine if you are disabled. In this post, we’re going to focus on Question #2: “Is your condition severe?”
According to Social Security, “your condition must significantly limit your ability to do basic work such as lifting, standing, walking, sitting, and remembering – for at least 12 months. If it does not, we will find that you are not disabled.”
As your disability lawyer, one of the first things we will do is review your medical records and ask you if you have any doctors willing to write a statement of support on your behalf. When looking at medical records, we’re not just trying to find out how often you went to the doctor or hospital, we’re also looking for information that is relevant to the medical conditions we believe may help you qualify as disabled.
If we don’t have any medical records that document diagnosis and treatment for your medical conditions, it will be difficult to prove that you are disabled. We also look for commentary and notes from your medical professionals that support our claim. We’re trying to paint a picture for Social Security of how your life is affected by your medical condition.
With that in mind, we often ask clients to contact doctors they believe will write them a brief statement of support that further supports their claim.
In our practice, we have developed specific forms for our clients to use for this purpose. Social Security also has a standard form that they call the “Medical Source Statement of Ability to Perform Work-Related Activities.” In other cases, we ask doctors who are willing to just write us their opinion in a letter. What form or letter we use all depends on what we think will be best for our client’s claim.
Using the house example again, a good disability lawyer is like the architect and general contractor of your claim. They create the plan and then help you build a strong claim built on solid medical evidence that will support a definition of “disabled.”
In closing, it’s important to remember that no one can guarantee a positive result. In our blog posts, we are summarizing complicated concepts and processes. That is why many people work with a disability lawyer to help them make sense of the process. You can find more basic information about Social Security Disability on our website.
If you want more specific advice about your claim, contact us today for a free evaluation.