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Will You Qualify for Benefits?

April 20, 2016 Blog

SS Disability InsIf you are unable to work due to a debilitating condition, you may qualify for Social Security Disability Insurance (SSDI) benefits. To successfully claim for SSDI benefits, you must meet all the requirements set out by the Social Security Administration (SSA), the most important of which in the eyes of Tampa disability benefits lawyers is whether you are “disabled.” Our Tampa Disability Benefits Lawyer can help you become qualified for Social Security Disability Insurance benefits.

“Disabled” as Defined by the SSA

To qualify for SSDI, you must fulfill several requirements such as age, citizenship, employment and residency.  The key requirement is whether you are considered “disabled” (or blind) as defined by the SSA.

The SSA defines “disability” as:

… not be[ing] able to engage in any substantial gainful activity (SGA) because of a medically-determinable physical or mental impairment(s):

  • That is expected to result in death, or
  • That has lasted or is expected to last for a continuous period of at least 12 months.

 What is “Substantial Gainful Activity”?

SGA is used to describe the level of work activity and earnings.

Your work is “substantial” if your duties involve significant physical or mental activities.  Your work could be either part-time or full-time so long as your earnings, for the year 2016, averages over $1,130 a month if your impairment is something other than blindness.  If you are blind, your earnings should average over $1,820 a month.

Your work is considered “gainful activity” if it is:

  • Performed for pay or profit
  • Of a nature generally performed for pay or profit
  • Intended for profit, whether or not you actually earn a profit

Are There Impairments Automatically Considered Disabling?

The SSA recognizes a number of impairments as disabling, and they are found in the Compassionate Allowances List (CAL) and Listing of Impairments.  If your condition is one of approximately 200 conditions that fall under CAL, your case may be fast-tracked and decided sooner.  Generally, these conditions are so severe that a simple diagnosis of the condition from a doctor will automatically qualify you for disability benefit, such as:

  • Lou Gehrig’s Disease
  • Acute Leukemia
  • Early-onset Alzheimer’s Disease
  • Gallbladder Cancer
  • Pancreatic Cancer
  • Small Cell Lung Cancer
  • Esophageal Cancer
  • Hepatocellular Carcinoma (type of liver cancer)
  • Anaplastic Thyroid Carcinoma (type of thyroid cancer)
  • Inflammatory Breast Cancer

However, other conditions on the list specify criteria for how severe your condition must be to qualify.  For example, malignant melanoma qualifies for CAL only if it has metastasized.  Some cancers only qualify for CAL after it progresses.

Not all severe or potentially fatal illnesses, such as AIDS, qualify for CAL.

Listing of Impairments

Conditions in the Listing of Impairments have criteria that you must meet before your condition qualifies for disability.   For example, to qualify for disability for central blindness, you need to have 20/200 vision or worse in the better eye, with contacts or glasses on.  To qualify for disability for chronic kidney disease, you need to undergo chronic hemodialysis or peritoneal dialysis.

A few of the medical conditions automatically qualify as disabilities with proof of their occurrence, such as transplant of your liver, kidney, heart or lung, or an cochlear implant.  But even if your condition falls under these “automatic disabilities,” SSA will reassess your condition after a year to determine whether you should still qualify for disability.

What If My Condition Does Not Meet the Listing of Impairments?

You may still receive benefits if your impairment “equals” a listing in the Listing of Impairments if:

  • You have a listed impairment, but it does not meet one or more of the specific criteria of the listing. If you have other medical conditions related to the listing that are of equal “medical value” as the requirements in the listing, your condition can equal the listing.
  • You have an impairment not listed but is similar to those outlined in one of the disability listings. Your condition can be equal to the listing if your impairments are medically equal to the impairment found in the listing.
  • You have a combination of impairments, but none meet a disability listing individually. Your conditions can equal the listing if the combined effect of your impairments medically equal to the impairments found in a similar listing.

How Do I Prove My Disability?

The Disability Determination Service (DDS) claims examiner or medical consultant reviews your medical eligibility for SSDI benefits.  You must show your diagnosis, prognosis, treatment, limitations and restrictions.  Tampa disability benefits lawyers frequently use the following types of evidence:

  • Medical Records – your records from all your treating medical providers should include your treating physician’s diagnosis, treatment history, and any objective evidence (x-rays, MRIs, CT scans, or laboratory test results) or physical examinations supporting your diagnosis. The records should also include notes regarding your symptoms, limitations and restrictions.  Often times, applications for SSDI benefits may be wrongfully denied because the DDS claims examiner received insufficient medical records.
  • Doctor Opinions – your treating physician’s narrative should include your diagnosis, support of your diagnosis, your treatment, prognosis, and your limitations and restrictions. He or she should provide an opinion on how long your condition has or is expected to last (at least 12 continual months) to support your disability claim.
  • Diary – your diary should track your symptoms and how they affect you.  You should note your good and bad days, whether you had to leave work or call in sick, if you had to seek assistance with your duties because of your symptoms, how long and when you experience your symptoms, what may have exacerbated your symptoms, etc.
  • Statements of Co-Workers, Supervisors, Friends and Family – these people may be familiar with how your symptoms negatively affect your daily and/or work life.

How We Help

When you are unable to work, it is important that you obtain effective assistance from one of the more experienced Tampa disability benefits lawyers.  If you call the Law Office of Mike Murburg, we will:

  • Discuss whether filing for SSDI benefits is right for you
  • Prepare the required forms for your application (or appeal)
  • Compile all necessary evidence supporting your disability claim
  • Determine the most effective arguments to make on your behalf
  • Provide zealous advocacy at your hearing

For assistance call (813) 264-5363 or toll free at 877-SSI-ATTY.