HOW I EVALUATE A SOCIAL SECURITY DISABILITY CLAIM

You think you have a disability claim that will pay off but you don't know much about the rules or the process.  You would like a professional to have a look at the case and see what your odds are, and what your next step should be.  

Here's what I look for when I evaluate a potentially new SSDI claim:

PART ONE:  DO YOU MEET THE TECHNICAL RULES?

1.  Has the claimant worked long enough and recently enough to to be covered under the SSDI (Title 2) program?  If not, no SSDI claim is possible on technical grounds.  I also need to find out when the claimant's "Date Last Insured" or DLI will occur or has occurred.  This is the date after which the claimant will no longer be insured for new claims under SSDI.

2.  Can the claimant meet the Duration Requirement?  Is there at least one single medical impairment that has lasted, or is expected to last for at least 12 straight months OR to end in death?  If not, there is no claim because there is no SSDI benefit for conditions not expected to last for at least 12 consecutive months.

3.  Is there medical evidence to prove a disability?  A person can be disabled but not be able to prove it.  We need doctor's records.

4.  Can the claimant meet a Social Security Listing?  Most do not, but may still get benefits.

5.  Can the claimant meet a Medical-Vocational Guideline?  These helpful rules are for individuals age 50 and over.  This is why older individuals have a better chance of winning their claim.  Besides age, other important factors include:  education, type of past jobs, and transferable skills.

6.  If the claimant meets no Listing and qualifies for no Medical-Vocational Guideline, can he prove that he cannot function well enough to work any full-time job?  In other words, he/she cannot do the sitting, standing, walking, lifting, bending, reaching, etc. required of jobs in today's work economy.  (Psychological limitations may also be considered).

PART 2:  THE MEDICAL/VOCATIONAL EVIDENCE

1.  What are the claimant's severe medical impairments?

2.  On what date did disability begin?  (The "alleged onset date")

3.  How severe are the symptoms, as found in the medical records?

4.  Is there any medical opinion concerning the claimant's functional limitations?  How much can he/she lift, stand, walk, sit, bend, stoop, kneel, crouch, crawl...., etc.?

5.  Has the claimant tried medical treatment and been consistently compliant with doctor's recommendations? 

6.  What was the skill and exertional level of past jobs, going back 15 years?

WHAT IS USUALLY BOILS DOWN TO:

For claimants under age 50 it usually boils down to this:  Can the claimant still perform any full-time job which exists in the US economy?  This includes unskilled sedentary jobs that often pay minimum wage.  If yes, the claim will be denied.

For claimants over age 50, especially 55 or older it boils down to this:  Can the claimant perform any of the past relevant jobs, meaning any of the full-time jobs he or she performed during the past 15 year period. If the answer is yes, the claim will be denied.

I can't emphasize enough the importance of objective medical evidence.  It isn't enough to claim that you can't work, you must prove that you can't work.  It's mostly about what the doctor says.

"What if the judge listens to my testimony and really believes that I am not able to work?  What will he/she do?"

In these cases, the judge often looks at the attorney/representative and says, "I believe your client is unable to work.  I feel she is disabled.  However, there is no medical evidence for me to base a decision on."  The claim is denied.

So, if you are thinking about filing a Social Security disability claim, you should consider whether or not you have recent medical treatment.  If not, you may want to obtain medical treatment before filing a claim.  Disabled individuals without medical treatment cannot win Social Security disability claims.
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THE FORSYTHE FIRM
7027 Old Madison Pike, Suite 108
Huntsville, AL 35806
"Across from Bridge Street"
CALL US:  (256) 799-0297

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