Applying for Social Security disability benefits can be overwhelming. The instructions can feel cryptic. Navigating the complex process can be very confusing for the average person. Social Security Disability Insurance (SSDI) payments are a much-needed lifeline for many people. But, the Social Security Administration (SSA) initially denies about 70 percent of SSDI applications. Often, this is due to paperwork errors or lack of medical evidence.
Save yourself from this frustrating and disheartening experience. By following the useful tips below, you can improve the chances that the SSA will approve your SSDI application.
Review the SSA Blue Book Listing
The Social Security Administration (SSA) lists qualifying conditions in its Blue Book. The list of impairments is broken down into several sections. These include musculoskeletal disorders, skin disorders, and immune system disorders, among other conditions. The medical listing for each disability outlines specific criteria for meeting that listing.
Search the SSA Blue Book for your condition. Check if your disability meets the listing requirements. For example, section 3.03 of the Blue Book describes the criteria to qualify for SSDI with asthma. One factor is to have a forced expiratory volume (FEV1) below a specific value given your age, gender, and height. It also requires complications requiring three hospitalizations in a 12-month period at least 30 days apart.
If you do not meet the criteria or your condition is not listed, you may still qualify for SSDI benefits. But, there is a greater burden of proof to support your disability benefits claim.
Check the Work and SGA Requirements
In addition to medical considerations, you must also meet other non-medical requirements to qualify for disability benefits. Two significant examples here are work credits and substantial gainful activity (SGA). For example:
- You need at least 40 work credits. Of these, 20 credits must be from the past ten years. Younger people may qualify with fewer work credits. You can earn up to four credits yearly based on your total yearly wages or self-employment income.
- You cannot exceed SGA thresholds for monthly income. For 2023, this amount is $1,470 for most people and $2,460 for blind individuals. You cannot earn more than this amount while receiving disability benefits.
See Your Doctor Regularly
It is imperative to see your doctor regularly about your condition. Before applying for SSDI, make an appointment with your primary care doctor. Discuss your application with them. Ask for medical evidence in support of your application. This can include lab test results. It should also have a written statement from your doctor about your condition and your ability to work.
Continue visiting with your doctor periodically. This can provide a documented timeline to describe the progression of your condition. Is it getting worse? Are you still unable to work?
Your doctor may already know about residual functional capacity (RFC) assessments. Ask them to complete one for you that you can include in your SSDI application. Note that even if your doctor says you are disabled, you do not automatically qualify for benefits. The SSA may ask for a consultative medical exam with an independent doctor after you apply. Social Security will pay for this exam.
Follow the Prescribed Treatment Plan
Seeing your doctor is one thing. They may be able to diagnose your medical condition. They can offer their professional opinion on your ability to work. If you do not follow their treatment plan, you are showing a lack of care or diligence to the SSA. The SSA may come to the conclusion your symptoms would improve if you stuck to your treatment. Seeking treatment and sticking with it can strengthen your disability benefits claim. It shows you are doing everything you can to get better.
This can include sticking to a regimen of medication. Depending on the condition, it may also involve physical therapy. Changes to diet and lifestyle may be prescribed as well.
Ask to See a Specialist
A family doctor is a general practitioner who is trained to have broad medical knowledge. While their opinion is certainly valued, specific expertise is even more valuable. This is why the SSA tends to give more weight to medical opinions from specialists. Invisible disorders are especially relevant.
If they haven’t already done so, ask your doctor for a referral to see a specialist. You may see an oncologist for cancer or a psychologist for a mental disorder. Just as with your family doctor, ask for supporting medical evidence to include as part of your claim.
Keep a Disability Journal
Professional medical opinions hold a lot of weight in your application. But, they don’t always offer a complete picture of your condition. They may overlook or misrepresent your day-to-day experience. A great way to offer this kind of insight is to keep a disability journal. This daily diary can track how your disability affects your life and the steps you take to manage it.
In it, you can discuss challenges you face with daily routines. Entries may describe sleep interruptions. Other details to record may include changes in your ability to groom yourself or prepare your own food. You may talk about mental and physical symptoms, plus any side effects of the medication. Describe your daily pain level, too. Is it more of a dull throbbing or a sharp stabbing sensation?
Provide Thorough Medical Evidence
Application denials are often due to insufficient medical evidence. According to Social Security, a disability can only qualify for disability benefits if it meets two main factors:
- You must be unable to do any substantial work because of your medical condition(s).
- Your medical condition(s) must have lasted, or be expected to last, at least one year or be expected to result in your death.
You must offer evidence that meets these criteria. This can involve a variety of documentation. It will depend on your disability and your individual experience. It may include a variety of test results, like blood tests and medical imaging. Written statements from your primary care doctor and medical specialists apply here, too.
Provide a complete medical history as part of your SSDI application. Offer official documents outlining your treatment history, medications taken, surgeries, etc. These should support not only the extent of your condition but also the claimed timeline. When were you first diagnosed? At what point were you unable to continue working? These records establish the onset of your disability.
With each document, provide the relevant contact information. This way, the SSA can follow up with the doctor or lab with any questions. As more medical records come in, continue submitting them to the SSA.
Check for Application Errors and Omissions
A disability benefits application can involve a lot of paperwork. It is easy to overlook a mistake or accidentally leave something out. It is vital to be vigilant about checking for these mistakes. Next to a lack of medical evidence, paperwork errors are a common reason the SSA can deny a claim.
You can complete the benefits application online, over the phone, or with your local Social Security office. Offer as much detail as possible with thorough, thoughtful answers. Simple “yes” and “no” answers often lead to denial. Make sure your application is correct and complete. Do not leave any questions blank.
To support claims about your inability to work and not exceeding SGA thresholds, include W2 forms and pay stubs as relevant.
Hire an Experienced Disability Attorney
The single biggest step you can take to improve your chances for SSDI approval is to work with a skilled disability attorney. The lawyers at Keefe Disability Law have years of experience handling a range of SSDI claims. Our team understands the complexities of the application process and can help present the strongest case possible to the SSA.
Starting with the Initial Application stage, we will work to compile compelling medical evidence in support of your disability benefits claim. We review all relevant information and documentation to ensure your application is accurate and complete.
You can rest easy knowing that we can correspond on your behalf and keep you updated on your application status. Our skilled lawyers can advise on what documentation to get and walk you through the process. And if needed, we can also guide you through the appeals process.
