A blog submitted by Peter Blake
PR Coordinator | Marasco & Nesselbush
In the first part of this blog we have discussed what’s Social Security Disability Benefits; SSDI, SSI, Who qualifies for each; Application process, How to apply and What information is needed in order to apply?
Now in the second part of this blog we will discuss further on Social Security Disability Benefits and why are most applicants declined; Qualifications under different disabilities etc.
Why are most applicants declined?
There are multiple reasons why an applicant may be denied benefits, but most denials come down to the severity and permanence of the disability.
The SSA uses five questions to determine if you’re disabled according to its criteria. The questions are:
● Are you currently employed and earning more than $1,310 a month?
● Is your condition severe enough to limit your ability to do basic work activities?
● Is your condition on the list of disabling conditions?
● Can you do the work you did before your disabling injury?
● Can you do other kinds of work despite your disability?
Other conditions that can affect your ability to collect SSDI include:
● Your disability won’t last for at least a year.
● You have an outstanding warrant for your arrest.
● You were convicted of a crime.
● You committed fraud to obtain SSDI or SSI.
Qualifications under different disabilities
The SSA has a list of qualifying disabilities, known as the SSA Blue Book, that helps you qualify for SSDI and SSI benefits. If you are suffering from any one of the following physical or mental disorders and are unable to work for at least a year, you can apply for benefits according to your employment status or needs.
Any disorder of the spine or upper or lower extremities that affects your ability to move freely. A musculoskeletal disorder can be congenital or acquired and can involve the bones, major joints, tendons, muscles, ligaments, and other soft tissues.
●Special senses and speech
This covers disorders of the eyes, ears, and mouth that impact your ability to see, hear, and speak. The SSA defines blindness under the Social Security Act sections 216(i)(1) and 1614(a)(2). Your blindness has to meet specific criteria in order to be eligible for SSDI or SSI.
The respiratory disorder category covers all disorders that cause obstruction or restriction in the lungs, or interfere with the diffusion of oxygen in the lungs. Disorders include cystic fibrosis, pneumoconiosis, asthma, chronic obstructive pulmonary disease, and lung transplants. The Blue Book has a chart that lays out the criteria for eligibility.
Any disorder that prevents the heart or circulatory system from working properly falls under this category. The condition can be congenital or acquired, and be the result of heart failure, myocardial ischemia, syncope, central cyanosis, and disorders of the veins or arteries.
Disorders of the digestive system are considered disabilities due to the fact they can make it difficult or impossible to focus for any length of time. They include liver dysfunction, gastrointestinal hemorrhage, short bowel syndrome, inflammatory bowel disease, and malnutrition.
Genitourinary disorders result in chronic kidney disease (CKD). They include diabetic nephropathy, chronic glomerulonephritis, chronic obstructive uropathy, hypertensive nephropathy, and hereditary nephropathies. You will need to provide medical paperwork that shows you are dealing with CKD as the result of any one of these conditions.
All non-cancerous blood disorders are considered under this disorder. That includes hemolytic anemia, disorders of bone marrow failure, and disorders of thrombosis and hemostasis.
The skin disorder listing covers skin conditions that are the result of ichthyosis dermatitis, hidradenitis suppurativa, chronic infections of the skin or mucous membranes, and more. The SSA requires a large amount of documentation to prove the fact your skin disorder is affecting your ability to work.
This disorder is evaluated by the impairment that results in an endocrine disorder. Some of the disorders include the pituitary gland, thyroid gland, parathyroid gland, diabetes mellitus, and other pancreatic glandoò disorders, hyperglycemia, diabetic ketoacidosis, chronic hyperglycemia, and more.
●Congenital disorders that affect multiple body systems
Only non-mosaic Down syndrome is evaluated for disability and has to meet the criteria that are listed under 10.06A of the Blue Book. A laboratory finding with karyotype analysis and a physician’s signature certifying the presence of Down syndrome is a key part of getting approval.
Multiple neurological disorders are considered disabilities as long as they cause disorganization of motor function, communication impairment, neuromuscular and bulbar dysfunction, or a combination of limitations in physical and mental functions. Cerebral palsy characterized by a marked limitation, disorganization, or significant interference in speech, hearing, or visual deficits is a disability covered by SSDI/SSI.
There are 11 categories for mental disorders. They include:
● Schizophrenia spectrum
● Depressive and bipolar
● Anxiety and obsessive-compulsive
● Somatic symptom
● Personality and impulse-control
● Eating disorders
● Trauma and stressor-related
●Cancer (malignant neoplastic diseases)
All cancers except those associated with the human immunodeficiency virus (HIV) can be evaluated for disability. An applicant needs to submit as much medical evidence that supports the diagnosis as possible, and supply the information required by the Blue Book.
●Immune system disorders
Immune system disorders are evaluated based on the dysfunction they cause in one or more parts of the immune system. Some of the disorders include lupus, systemic vasculitis, scleroderma, inflammatory arthritis, and more.
How are SSDI payments calculated?
The amount you receive from SSDI is based on the average income you earned before you were disabled. The type or severity of your disability does not factor into the benefit. The SSA has a formula that pays a percentage of your income at increasing levels. For example, in 2022 the SSA will pay:
● 90% of the first $1,024 of average monthly earnings, plus
● 32% of average monthly earnings over $1,024 through $6,172, plus
● 15% of average monthly earnings over $6,172
Can you work while on Social Security Disability?
Yes, you can work while you’re receiving SSDI or SSI. The program has special rules that are designed to help people transition from SSDI to full employment over time. You can enroll in a trial work period that lasts nine months, keep your earnings below the monthly limit ($1,310 in 2021), or enroll in the Ticket to Work program. If it so happens that an SSDI recipient can’t maintain employment for any reason and their benefits have stopped, they can start receiving benefits again and may not need to reapply.
What caretakers need to know
Caretakers, or caregivers, can apply on behalf of a family member or friend, but the person who is to receive the benefits has to sign the application and other related documents. The only way a caregiver can sign is if they have power of attorney or are a legal guardian. SSDI/SSI will not pay the wages of a caregiver, but the recipient can use the money for wages and other costs of caregiving if they so choose.
Blindness and benefits
You can apply for and receive SSDI or SSI if you’re blind or your vision problems alone or with other health problems prevent you from working. SSDI requires you to have paid into Social Security through payroll taxes, whereas SSI doesn’t. If you don’t have enough credits for SSDI from your wages, you may be able to use the credits of a parent or spouse. You’re also allowed to work while receiving SSDI and earn a much higher amount every month ($2,190 in 2021) in wages and self-employment than you would if you had normal sight.
SSDI benefits and retirement
The amount provided by SSDI benefits may or may not be enough to live off of. Recipients of SSDI/SSI can usually take advantage of other government programs such as Medicare and Medicaid to reduce medical costs, SNAP benefits for food, and subsidized housing.
How can a law firm help?
The law firm of Marasco & Nesselbush in Woonsocket, Rhode Island, can help you pursue an SSDI or SSI claim and improve your chances of getting approved for benefits. Applying for Social Security Disability is an involved process that requires providing sufficient documentation by a deadline. Missing the deadline may result in you starting the application process all over again. You also run the risk of being barred from ever applying for SSDI again. Getting help from Marasco & Nesselbush helps you avoid the pitfalls of applying for SSDI.
Our team understands the application process and what the SSA is looking for in terms of information, and we can obtain the medical opinion that’s needed to support your claim. If you’re denied, we handle the appeals process and represent you in front of an administrative law judge. We advocate for you until you receive the benefits that you are legally entitled to.
Author Peter Blake
PR Coordinator | Marasco & Nesselbush [ TOP RATED INJURY ATTORNEY Firm of USA]
Creative representation for this blog is done by our extremely talented CreativeSaathi associate Vinayak Raj