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Boost Your SSDI Claim With Combined Effects
Boost Your SSDI Claim With Combined EffectsMany people think they can only list one medical condition when they apply for disability benefits. They believe this is the only way to qualify for Social Security Disability Insurance (SSDI). The reality is that a person’s ability to work can be affected by several conditions. The Social Security Administration (SSA) considers an applicant’s disability as a whole. As such, it’s vital to include all physical and mental impairments on an SSDI claim. Include all relevant physical injuries, illnesses, and psychological conditions, even if some may seem minor and not that severe.
Providing the Bigger Picture of Disability
Qualifying for SSDI often focuses on medical requirements. This may include a variety of specialized tests for various medical conditions. Meeting the non-medical requirements is equally important. Of primary importance is the concept of substantial gainful activity (SGA).
Substantial Gainful Activity
The Social Security Administration considers a person disabled if they are unable to engage in substantial gainful activity due to a physical or mental impairment. This impairment must last or be expected to last at least 12 months or be expected to result in death.
Substantial gainful activity is based on income. For 2024, the monthly SGA amount for non-blind individuals is $1,550. For people who are statutorily blind, the SGA amount is $2,590 per month. This means you cannot earn more than this amount if you want to receive disability benefits.
Note that the SSA’s definition of disability is not tied to any single medical condition. Rather, the SSA will look at the totality of an applicant’s ability to engage in SGA. This means that even if someone doesn’t qualify with one illness, they may be eligible for SSDI based on the combined effect of multiple medical conditions.
It’s not just about the primary or most severe impairment you have. Rather, by including all the secondary conditions you have, you can strengthen your claim to receive disability benefits.
Combined Effects of Concurrent Conditions
The interaction between conditions can help create a more compelling argument to prove you are disabled. For instance, someone’s rheumatoid arthritis may worsen during intense bouts of anxiety. Or, while their cancer-related symptoms may only be moderately severe, the added effect of recurrent arrhythmia may be especially debilitating.
During step two of the evaluation process, the SSA evaluates the severity of your impairments or combination of impairments. Medical records and doctor’s reports can serve as evidence.
Specifically, the Social Security Code of Federal Regulations § 404.1523 outlines multiple impairments. The SSA “will consider the combined effect of all of your impairments without regard to whether any such impairment, if considered separately, would be of sufficient severity.” Similarly, if an impairment is expected to improve within 12 months so the combined effect is no longer severe, you may not meet the 12-month duration test.
SSDI Benefit Amounts With Multiple Conditions
Benefit amounts do not depend on the number of benefits contributing to your disability. The payment is the same whether you qualify based on one or several conditions. SSDI payments are based mainly on your work history.
Evidence to Equal a Blue Book Listing
One way to qualify for disability benefits is to meet a listing in the SSA Blue Book. The book lists specific criteria for specific conditions. If you meet the specific criteria for a listing, you are automatically considered disabled for SSDI purposes. For example, one criterion for 3.03 Asthma is to have a forced expiratory volume (FEV) less than a specific number based on age, gender, and height.
If you do not meet the specific requirements for a single listing, you may still qualify for benefits. To do this, you may “equal” a Blue Book listing with multiple conditions. The combined effect of the impairments must be “medically equivalent” to the listing criteria. This is typically based on medical evidence and the expert opinions of medical consultants.
For example, if your FEV is close to the required value for asthma and you have another condition that exacerbates symptoms, you may “equal” the listing and be eligible to receive disability benefits. It is crucial to include impairments and disabilities even if they are not part of the Blue Book listing of impairments. Their combined impact on your ability to work is what matters.
Complete a Residual Functional Capacity Assessment
If you don’t have a single medical condition that meets a specific Blue Book listing or if the combined effect of several secondary conditions still does not equal a specific listing, this does not necessarily mean you are ineligible to receive disability benefits. Another option to consider is a residual functional capacity (RFC) assessment.
To be completed with your doctor, an RFC assessment looks at functional limitations concerning your ability to work. To qualify for SSDI in this manner is called a medical-vocational allowance. With your conditions in mind, your doctor looks at physical and mental limitations that may prevent you from working different types of jobs. These include sedentary, light, medium, heavy, or very heavy work. Limitations may include:
- Exertional restrictions like lifting, carrying, sitting, standing, and walking
- Manipulative restrictions like using your arms, hands, and fingers to perform tasks
- Postural restrictions like bending, reaching, stooping, and balancing
- Sensory restrictions like speaking, seeing, or hearing
- Mental restrictions like following instructions and making decisions
- Social restrictions like collaborating with coworkers and interacting with the public
- Environmental restrictions like extreme temperatures, vibrations, and fumes
The result of an RFC assessment should accurately describe what work you can do despite the impairments that you may have. For example, if you have severe back pain due to a medical condition, you may still be able to do clerical work at a desk with a cushioned seat.
The SSA also factors in past work experience, as well as age and education. A person who can return to past relevant work is not deemed disabled. A person who has only done manual labor in a warehouse setting may not be able to pivot to secretarial work in an office setting. Perhaps they have very poor typing skills and no software knowledge.
Older applicants are provided with greater leniency with the SSA’s medical-vocational grid rules. An SSDI applicant over the age of 60 may qualify for SSDI with the same symptoms as a younger applicant who may be denied. Presumably, it is easier for a younger person to adjust to other work. They can seek vocational training or education. If you can adjust to other work, the SSA will decide you are not disabled.
The Skilled Guidance of Experience
It is possible to apply for Social Security Disability Insurance (SSDI) on your own. However, this is not advisable. The SSA denies the majority of SSDI claims the first time around. Sometimes, the denials may be due to technical mistakes, like not providing sufficient documentation about work history and substantial gainful activity.
Often, the SSA denies disability applicants due to a lack of medical evidence. It is crucial to present as compelling a case as possible to the SSA. Even if you think you’ve demonstrated that you are disabled, the SSA may argue that you are still able to perform other work. As a result, they may deny your claim to receive benefits.
This is why it is so critical to turn to a skilled SSD lawyer like John Keefe. Our qualified attorneys at Keefe Disability Law have years of experience specifically dealing with SSDI applications. We will work with you to create a compelling argument, clearly connecting your secondary conditions, grounded in undeniable medical evidence. And, if needed, we can help appeal your case and obtain the benefits you need and deserve.
“I can have peace of mind now,” writes satisfied KDL client Leo C. of Lynn, Massachusetts. “Social Security makes it hard for people who are really sick. I now sleep a little better.” We are on your side every step of the way.
