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Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are two federally funded programs that provide financial assistance to individuals with disabilities. These programs have strict eligibility criteria, one of which is having a medical condition that qualifies as a disability under the Social Security Administration’s definition. In this article, we will explore the types of medical conditions that are covered by Social Security Disability and those that are not. We will also discuss the process of applying for disability benefits and how medical evidence plays a crucial role in determining eligibility. Whether you are considering applying for disability benefits or simply curious about what conditions are covered, this article will provide valuable information to help you better understand Social Security Disability coverage. What Is Considered a Disability? According to the Social Security Administration (SSA), a disability is a physical or mental impairment that prevents an individual from engaging in substantial gainful activity (SGA). In simpler terms, this means that the condition must be severe enough to significantly limit a person’s ability to work and earn a living. The SSA has a strict definition of what qualifies as a disability. The condition must be expected to last for at least 12 months or result in death, and it must prevent the individual from performing any type of work, not just their current job. Additionally, the SSA requires that the condition must be medically determinable, meaning there is sufficient evidence to support its existence and severity. This can include medical records, test results, and statements from treating physicians. It’s also important to note that the SSA does not provide benefits for partial or short-term disabilities. The individual must have a condition that is expected to last at least a year or result in death to be eligible for disability benefits. Does Social Security Disability Cover All Medical Conditions? The short answer is no, Social Security Disability does not cover all medical conditions. The SSA has a specific list of medical conditions that are considered disabling and automatically qualify for disability benefits under the Compassionate Allowances program. However, just because a condition is not listed on the SSA’s list does not mean it cannot be considered a disability. In fact, many individuals with unlisted conditions are still able to receive benefits by proving their condition meets the criteria for a disability. In general, any medical condition that significantly impacts an individual’s ability to work and earn a living can potentially be considered a disability. This includes physical impairments such as chronic illnesses, injuries, and disabilities, as well as mental health conditions like depression, anxiety, and schizophrenia. Ultimately, the SSA will evaluate each case individually and consider the severity of the condition and its impact on an individual’s ability to work when determining eligibility for disability benefits. Therefore, it is important to provide thorough medical evidence supporting your claim for disability benefits. Eligibility Of Medical Conditions: What Evidence Is Required? As mentioned earlier, medical evidence plays a crucial role in determining eligibility for disability benefits. When applying for SSDI or SSI, you will need to provide detailed information about your medical condition and how it affects your ability to work. This can include medical records from doctors, hospitals, and clinics, as well as test results such as x-rays or MRI scans. It is also helpful to have statements from treating physicians that describe the severity of your condition and how it limits your daily activities. In some cases, the SSA may require you to undergo a consultative examination with a doctor of their choosing to further evaluate your condition. These exams are at no cost to you, and the results will be considered in your disability claim. It is important to provide as much relevant medical evidence as possible when applying for disability benefits. This can significantly increase your chances of being approved and receiving the financial assistance you need. Benefits Of Applying For Social Security Disability Benefits There are many benefits to applying for Social Security Disability benefits. First and foremost, it provides financial assistance to individuals who are unable to work due to a disability. This can help cover living expenses, medical bills, and other necessary costs. In addition, being approved for disability benefits often comes with access to healthcare coverage through Medicare or Medicaid. This can be especially beneficial for individuals with chronic illnesses or disabilities that require ongoing medical treatment. Receiving disability benefits can also provide a sense of security and stability for individuals who are no longer able to work. It can alleviate financial stress and allow them to focus on managing their condition and improving their overall quality of life. Lastly, being approved for disability benefits can also open up opportunities for vocational rehabilitation and training programs. These can help individuals with disabilities find new ways to work or engage in activities that are manageable with their condition. How Much Can You Receive In Social Security Disability Benefits? The amount of disability benefits an individual receives through Social Security is based on their average lifetime earnings before they became disabled. The SSA uses a complex formula to calculate the benefit amount, taking into account the individual’s age and number of years worked. On average, most individuals can expect to receive between $800-1,800 per month in disability benefits. However, some individuals with higher lifetime earnings may receive more. Additionally, there are programs within Social Security that provide supplemental income for those who have limited resources and income due to a disability. These include Supplemental Security Income (SSI) and the Special Veterans Benefit program. It’s important to note that disability benefits are not meant to replace a person’s entire income, but rather provide financial support while they are unable to work. The SSA also has strict guidelines for individuals who receive disability benefits and engage in part-time or limited work activities. Why A Professional SSDI Attorneys’ Help Is Crucial The process of applying for Social Security Disability benefits can be complex and overwhelming, especially for individuals who

The Social Security disability process is a long and winding road, and even after a claimant has been found disabled by the Social Security Administration and award benefits, it is important to remember that Social Security Disability Insurance (SSDI) benefits are not permanent benefits. Social Security will review a claimant’s medical condition periodically to ensure the claimant remains disabled and entitled to benefits. A Continuing Disability Review (CDR) is conducted by Social Security once every three years for claimants who are expected to medically improve from their conditions. Even if Social Security determines a claimant’s impairments are not expected to improve over time, Social Security will still review a claimant’s case every five to seven years. When Social Security decides to conduct a CDR, the agency will contact the beneficiary to get updated medical treatment information from the beneficiary’s treating sources to determine if they are still eligible to SSDI benefits. Social Security will also review a beneficiary’s income, resources and living arrangements to ensure the beneficiary meets the non-medical requirements for Social Security’s disability programs. It is in the best interest of the beneficiary to participate in the CDR process and to provide Social Security with all requested information during the review process. Failure to comply with Social Security’s requirements could result in the termination of benefits. If you received a CDR notice from Social Security and are interested in assistance, please contact Greeman Toomey PLLC at 877-332-3252 for a free consultation.

To qualify for Social Security Disability Insurance benefits, generally you must have worked and paid into Social Security for at least five years within the past ten years. According to Social Security rules, a claimant must meet specific medical requirements to qualify for Social Security disability benefits. These can include a developmental disability, long-term disability, a mental health diagnosis or any other limiting medical condition that limits a claimant’s ability to work. To receive SSDI payments, the applicant must show evidence that their disabling condition will last for at least twelve months or result in death. Getting started on a disability claim can be difficult if you don’t know where to start. Below are some details of how to begin a disability claim. Options To File The SSA provides three ways to apply for disability: You can go online and fill out the application, visit your local Social Security office and fill it out with a Social Security representative, or do it over the phone. You can apply for SSDI online at www.ssa.gov/pgm/disability.htm. In-person. If you want to apply for SSI or SSDI in person, visit your local SSA field office. The employees there can help you with the paperwork and explain the forms, but they cannot give legal advice. Go to the SSA’s website to find your local field office in Minnesota. By telephone. You can apply for SSI or SSDI by phone. If your field office is too distant or if you have a disability preventing travel, this may be a better solution for you. You can call 800-772-1213 and apply by phone, or if you are deaf or hearing impaired, call 800-325-0778. If you are interested in a free consultation about Social Security disability please contact Greeman Toomey law office at 612-332-3252.

  The Social Security Administration recently announced that the agency was reducing the requirement for disability claimants to document Past Relevant Work in making disability determinations. Beginning June 22, 2024, Past Relevant Work will consist of the past five years of employment compared to the current rule that requires the agency to consider the last 15 years of work history to be considered Past Relevant Work. The rule change should make applying for disability easier and reduce the requirement for claimants to gather information about a job they may have had many years ago. In a summary of the new rule, Social Security indicated the rule change will also better reflect current evidence about a worker’s skill level and job responsibilities when making disability determination. “These changes will reduce the burden on individuals applying for disability by allowing them to focus on the most current and relevant information about their past work,” Social Security wrote. The move is also expected to reduce processing times for disability claims and improve customer service, the agency said. Currently there are steps in the disability determination process that evaluate a disability claimant’s ability to perform their Past Relevant Work and whether a claimant has acquired job skills from past relevant work that would transfer to other jobs. This new rule will now limit past relevant work to five years instead of 15 and no longer requires a claimant to detail job skills that were obtained over a decade ago, making it more beneficial to the claimant.

Social Security routinely sends claimants out for Consultative Exams (CEs) with an independent doctor during the early stages of the Social Security disability process, but sometimes a claimant will be requested to attend one of these exams even after they have a hearing with an Administrative Law Judge (ALJ). Although not the standard, it is also not uncommon for judges to send claimants out for an exam if the ALJ is unable to decide on disability claim because of a lack of medical evidence. No matter when a CE is ordered, it is imperative that the claimant attend the exam as scheduled. Failure to attend can result in the denial of a claim. After the exa,m the medical professional conducting the exam will issue a report to Social Security on the findings. The exam is not the only evidence used to issue a decision in a disability claim, but it is still important to attend. There are different types of exams a claimant may be required to attend. There are physical exams and mental health exams that are typically required based on the impairments the claimant is diagnosed with. A claimant will be notified several weeks prior to the scheduled exam. Below is information on Social Security’s protocols related to CE exams. If the evidence provided by the claimant’s own medical sources is inadequate to determine if he or she is disabled, additional medical information may be sought by recontacting the treating source for additional information or clarification, or by arranging for a CE. If you are interested in learning more about applying for Social Security disability and would like a free consultation, please contact Greeman Toomey Law Office at 612-332-3252 or visit www.greemantoomey.com.

One of the essential requirements for obtaining Social Security disability is proof of a debilitating medical condition. One of the most common reasons for SSDI claim rejections is inadequate documentation of an injury or illness. It may sound simple enough to collect your own medical records and submit them to Social Security, but it can be time consuming and Social Security has deadlines in place for when records need to be submitted. Typically, claimants who apply for disability have medical evidence from many different treatment sources, and records can consist of medical evidence that spans over several years. This could result in hundreds of pages or even thousands of pages of medical records that need to be submitted to Social Security. Claimants always have the option of seeking the assistance of a Social Security disability attorney or representative, which can be helpful in obtaining records. Below are acceptable forms of medical evidence Social Security will accept in deciding a disability claim. • Contact information for all medical personnel who have treated you, including doctors, clinics, and hospitals. • Dates of diagnoses, hospitalizations, doctor’s visits, treatments, or operations may be included. • Laboratory findings and test results are available. • A list of all the prescription medications you have taken for your disability, how long you have been taking each medication, and how well it works. • Clinical reports, medical histories, findings, treatment history, and prognoses.

The Social Security disability process is a long and winding road, and even after a claimant has been found disabled by the Social Security Administration and award benefits, it is important to remember that Social Security Disability Insurance (SSDI) benefits are not permanent benefits. Social Security will review a claimant’s medical condition periodically to ensure the claimant remains disabled and entitled to benefits. A Continuing Disability Review (CDR) is conducted by Social Security once every three years for claimants who are expected to medically improve from their conditions. Even if Social Security determines a claimant’s impairments are not expected to improve over time, Social Security will still review a claimant’s case every five to seven years. When Social Security decides to conduct a CDR, the agency will contact the beneficiary to get updated medical treatment information from the beneficiary’s treating sources to determine if they are still eligible to SSDI benefits. Social Security will also review a beneficiary’s income, resources and living arrangements to ensure the beneficiary meets the non-medical requirements for Social Security’s disability programs. It is in the best interest of the beneficiary to participate in the CDR process and to provide Social Security with all requested information during the review process. Failure to comply with Social Security’s requirements could result in the termination of benefits. If you received a CDR notice from Social Security and are interested in assistance, please contact Greeman Toomey PLLC at 877-332-3252 for a free consultation.

During a Social Security Disability claim the term “Date Last Insured” is likely to be an important factor in determining eligibility for Social Security Disability Insurance (SSDI) benefits. The Date Last Insured (DLI) refers to the last work quarter in which the disability claimant met Social Security’s insured status requirements. The DLI is established to ensure a claimant has established enough of a work history to meet technical requirements of the program. In most cases, individuals would qualify for Social Security Disability benefits if they had worked five out of the ten past years before the onset of the disability. Regardless of your disabling condition, your date last insured is one of the first things Social Security looks at when evaluating your claim. A claimant’s DLI plays an important role in determining eligibility for Social Security Disability benefits, but can be difficult to understand. Your date last insured is an important consideration from both the medical and the technical standpoint of your claim. Technically, you must have had enough quarters of coverage to have a DLI date. Medically, you need to show you became disabled before your date last insured. If a claimant does not have enough work credits to establish a DLI one other option is to also apply for Supplemental Security Income (SSI). This program also provides disability benefits to claimants who have been found medically disabled. The SSI program is a needs-based program for claimants who meet low income and asset standards. If you are interested in applying for Social Security disability benefits, please contact Greeman Toomey PLLC at 877-332-3252 for a free consultation.

There are several reasons why so many Social Security disability applications are denied. When it comes to medical eligibility the main reason is that the SSA has strict eligibility requirements, and many applicants do not meet these requirements. For example, to be eligible for SSDI, you must have a disability that is expected to last at least 12 months or result in death, and you must have worked and paid Social Security taxes for a certain number of years. Social Security also uses stringent medical analysis to deny claims. The process is also a long one, as Social Security remains understaffed and underfunded. A decision on an initial application for disability benefits can take up to six months, sometimes longer before a decision is made and most of that time the claim is denied, and an appeal is needed. If an initial claim is denied it is not the end of the claim, but an appeal will need to be filed. Below is an explanation of the different appeals that can be filed based on the level of the denied claim. The Four Levels of Social Security Disability Appeals If your Social Security disability claim is denied, you have the right to appeal the decision. There are four levels of appeal: Reconsideration: At this stage, your case will be reviewed by a different SSA examiner than the one who reviewed your initial application. Administrative Law Judge (ALJ) Hearing: If your claim is denied after reconsideration, you can request a hearing before an ALJ. The hearing is usually held within 75 miles of your home and is an opportunity for you to present evidence and argue your case. Appeals Council Review: If your claim is denied after the ALJ hearing, you can request that the SSA Appeals Council review your case. The Appeals Council can either overturn the ALJ’s decision, send your case back for another hearing, or uphold the decision. Federal Court: If your claim is denied at the Appeals Council level, you can file a lawsuit in federal court. If you are interested in a free consultation about applying for Social Security disability benefits, please contact Greeman Toomey PLLC at 877-332-3252

Most Social Security disability claims are denied at the initial application phase and even a higher percentage are denied at the first appeal stage of the process. Most of these claims are denied for a variety of common reasons that claimants should be aware of before applying for benefits to give claimants the best opportunity to be successful with their claim. Below we look at the most common reasons a disability claim is denied. Technical Denial A technical denial is a denial based on eligibility criteria that has nothing to do with medical evidence in a case and is sometimes call a “non-medical denial.” A claimant can receive a technical denial for different reasons including too much work-related income or non-work-related income for Supplemental Security Income (SSI) claims. A technical denial can also be issued if a claimant has not worked long enough and more recently enough to be eligible for Social Security Disability Insurance (SSDI) benefits. Technical denials are typically not appealed unless Social Security has made miscalculations on a claimant’s work history or their income and assets. Medical Denial Cases are often denied because Social Security determines that there is not sufficient medical evidence to support a finding of disability. An unfavorable medical decision will typically include language indicating a claimant’s condition is not considered disabling and not severe enough or the condition is severe, but not expected to last at least 12 months as Social Security requires. It is important to send all available medical evidence to the Social Security Administration to help enable them to make an informed decision and to appeal medical denials if you feel your condition is disabling.