When doctors share difficult diagnosis information with their patients, they never utter the dreaded and feared words “You have a disability.” This word is quite subjective. Different conditions affect people differently. For example, fibromyalgia’s effects range from completely disabling to barely noticeable. Additionally, “disability” is not just a medical term. In this context, this word also has educational, vocational, economic, and other implications. More on that below.
Just like doctors never say “You have a disability,” Social Security Disability applicants never say “I have a disability so where is my check?” The process is much more complex, especially if your condition inhibits your daily life but it is not a presumptively-disabling condition.
In these situations, a dedicated SSA law firm such as Heermans Social Security Disability Law Firm gets to work for you. We know the law, and we know how to make it work for you. Furthermore, because of our experience, we know all the procedural rules and best practices. That includes the unwritten rules.
Blue Book Conditions
According to the Social Security Administration, some conditions are presumptively disabling. Essentially, these conditions always significantly affect a person’s daily routine. These specific disabling conditions are called “listings.”
To qualify, the diagnosis must be recent and specific. Recent diagnoses are usually less than six months old. Additionally, the diagnosis must list specific symptoms and the effect of those symptoms. A specific diagnosis enables a Claims Examiner to accurately determine the disability percentage. A general diagnosis usually requires a second opinion, and that means your benefits are delayed.
The SSA updates and revises this list once every year or two. As of January 1, 2020, it included the following conditions:
- Musculoskeletal problems, such as chronic serious back issues,
- Cardiovascular issues, including coronary artery disease and congestive heart failure,
- Sensory problems, such as hearing or vision loss,
- Respiratory issues, including asthma and COPD,
- Emotional and mental problems, such as extreme anxiety, clinical depression, or severe autism,
- Autoimmune disorders, including lupus, HIV/AIDS, and rheumatoid arthritis
- Various syndromes, such as Down’s Syndrome or Marfan Syndrome
- Neurological disorders, including cerebral palsy, Parkinson’s disease, MS, and epilepsy
- Skin disorders, such as eczema,
- Digestive tract issues, including IBS and liver disease,
- Kidney disease,
- Cancer, and
- Hematological disorders.
The SSA fast-tracks some presumptive claims, mostly cancer claims. In other cases, the wait for benefits might be rather long. These are uncommon, however, and most applicants for disability benefits will not be subject to expedited approval by SSA.
Additionally, unless the diagnosis states the condition is permanent, disability awards are usually not permanent. The SSA normally requires periodic re-evaluations.
SSI Lawyers Near Me and Non-Blue Book Conditions
Many people reviewed the above list and, if their condition was not on it, they assumed they did not qualify for benefits. That’s simply not true. Roughly 50 percent of all successful Social Security Disability claims involve non-Blue Book conditions. However, since the presumption does not apply, claimants must establish the following two elements to obtain disability benefits.
Residual Functional Capacity (RFC)
Medical evaluators at DDS (Disability Determination Services) facility usually measure RFC. Frequently, they examine medical records and base their conclusions on them. Other times, they ask claimants to perform basic exercises. The RFC is usually one of the following:
- Very Heavy Work: This designation is usually the death nail for a disability claim. If people can occasionally lift more than 100 pounds and consistently lift more than 50 pounds, they can presumably work pretty much anywhere.
- Heavy Work: If the respective weight limits are up to 100 and 50 pounds, the person can perform most white collar jobs. A few blue collar semi-professional jobs, like electrician and plumber, might be an option as well.
- Medium Work: Claimants who can only occasionally lift up to 50 pounds and regularly lift 25 pounds are usually limited to office jobs. They can also occasionally move boxes.
- Light Work: Persons who can regularly lift 10 pounds and occasionally lift 20 pounds can usually stand up and sit down without much of a problem. Frequent walking is usually possible as well.
- Sedentary Work: These individuals can lift files and small office tools, such as staplers and hole punchers, but that’s the extent of their physical ability. Technically, they can occasionally lift up to 10 pounds, and consistently lift the aforementioned small objects.
If the claimant has an emotional condition, like anxiety, the RFC is done differently. DDS evaluators try their best. Occasionally, however, an attorney needs to partner with an independent medical expert. More on that below.
Medically Determinable Impairment (MDI)
The SSA defines this term as “an impairment that results from anatomical, physiological, or psychological abnormalities that can be shown by medically acceptable clinical and laboratory diagnostic techniques.” Let’s break this down.
Impairment is not synonymous with impediment. Essentially, an impairment is a set of circumstances which makes an activity more difficult. The degree of difficulty usually determines the disability rating.
The chronic nature of the condition, or lack thereof, plays a part as well. However, this portion of an impairment is often difficult to measure. Most people with chronic conditions have good days and bad days.
Abnormality usually means a tangible problem. Depression is a good example. Situational depression, perhaps over the loss of a loved one, can be as bad as clinical depression, which is a chemical imbalance in the brain. Yet only clinical depression qualifies for disability benefits.
Additionally, according to the SSA, the condition must be harmful, either to the claimant or to other people. That harm could be physical or psychological, but it must be measurable.
The final element, medically acceptable, gives attorneys some flexibility. Most general practice doctors are qualified physicians, but they may not regularly be called upon to diagnose disabling conditions. This could potentially jeopardize a patient from being properly assessed and therefore from being properly diagnosed with a disabling condition. Attorneys often partner with top experts to present compelling medical evidence which, although unorthodox, is on point.
At Heermans Social Security Disability Law Firm, we are committed to maximum compensation for your serious disability. We are committed to helping our clients in the Greater Midsouth area assess their social security disability claim conditions both pre and post submittance to the Social Security Administration. We can be reached at (901) 244-0057 by phone or text or you can send us a message here.
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