Almost everyone has at least one pre-existing medical condition. Usually, the older we get, the more conditions we have, and most Social Security Disability applicants in the Memphis metro area and mid-south region of Mississippi, Arkansas, and Louisiana are middle aged or older adults. So, pretty much all SSD applicants ask themselves and Heermans Social Security Disability Law Firm if they can apply for SSD benefits while experiencing other medical conditions. In a nutshell, disability benefits are usually available in these cases, thanks to the eggshell skull rule.
This rule’s principle is quite straightforward. To a Heermans Social Security disability attorney, the DDA, or a defendant in a civil case, must take victims as they find them. Just like an egg that is fragile and has been cracked – it’s very hard to put it back together. In layman’s terms, schoolyard bullies shouldn’t pick on kids just because they’re small, and Disability Determination Services officers shouldn’t deny benefits to applicants just because they have pre-existing conditions. Of course, this is the way it should be in an ideal situation, but works much better when your application for disability is represented by a Heermans attorney. An attorney helps make sure that your SSD application, or re-application demonstrates your need for disability benefits without being jeopardized for having other conditions prior to the one that caused your disability.
However, as they say, the devil is in the details. Usually, the eggshell skull rule only applies if a subsequent illness or injury aggravated a pre-existing condition. If that analysis doesn’t make much sense to you, we really do understand how confusing this can be. There’s a very fine line here. So, the disability lawyers near you at the Heermans Social Security Disability Law Firm can help you speak with independent doctors in these situations. These physicians give their expert opinions as to what aggravated what. Not just any doctor will do. These experts are highly credentialed and also able to provide DDS officers with the required medical assessments without using too much “Med-speak” so that your application can process efficiently and quickly.
Eye on the Prize: Benefits Available
Before we dive into specifics about the eggshell skull rule and pre-existing conditions, let’s look at the benefits available in an SSDI claim. In our experience, when both attorney and client keep their eyes on the prize, the road to financial benefits seems to be less long and winding.
In terms of monthly cash, similar plans, like VA disability, often use the nature and extent of the disability to determine monthly payment amounts. But to the SSA, there’s no such thing as partially disabled. You’re either disabled or you aren’t. So, the SSA uses a complex formula to determine the amount. This formula considers things like the age (including children) of the applicant, average indexed monthly earnings (AIME), primary insurance amount (PIA), and some other factors which might make your head spin. This complex formula is all the more reason to trust your SSD application to a Heermans Disability Attorney.
On average, most applicants receive between $800 and $1,800 a month. SSDI, by itself, may not be enough to live on. But when combined with the other Federal, State, and local level benefits these individuals may qualify for, and considering the fact that recipients can still work part time, the benefits are more than enough to be life-changing.
As mentioned, the road to benefits is never short and straight. The process usually takes at least several months. Typically, the financial benefits are retroactive to the application date.
Additionally, and perhaps more importantly, most SSDI recipients are eligible for Medicare. A waiting period usually applies for these medical benefits.
Involuntary Pre-Existing Conditions
Technically, all pre-existing conditions are created equally, at least as far as SSDI applications are concerned. However, we’re all human, including disability lawyers, DDS officers, and Administrative Law Judges. These last two categories of people are the ones who ultimately determine whether to award benefits or not. It’s easier to apply the eggshell skull rule if the pre-existing condition was involuntary, like:
- Age: Gravity and the environment take a toll on our bodies. Over time, gravity weakens the joints and affects the heart and other internal organs. Additionally, environmental toxins, including the sun’s radiation, are everywhere. Day-to-day exposure is extremely low, but it accumulates over time.
- Genetics: Some people have genetic predispositions to certain illnesses and injuries. Sometimes, doctors can anticipate these vulnerabilities and people can plan their lives accordingly to avoid certain behaviors. Other times, the person has no idea s/he is vulnerable until it’s too late.
- Prior Injury or Illness: This pre-existing condition is often the “big one” SSD applicants worry about. Many illnesses and injuries never entirely heal. The lingering effect causes weakness and unusually high vulnerability to a subsequent episode.
Generally, these pre-existing conditions are mild, or at the most, moderate. Therefore, it’s easier to apply the key principle of the eggshell skull rule, which is that aggravation thing we mentioned above. For example, Jerry’s bad knee might make him more susceptible to a debilitating knee injury. However, unless Jerry gets hurt, his bad knee usually isn’t a problem. So, the line is clear.
Voluntary Pre-Existing Conditions
In contrast, voluntary pre-existing conditions are usually more serious. They could create so much weakness and vulnerability that even a little push could cause a disabling condition. Therefore, it’s harder to apply the aggravation element of the eggshell skull rule.
Fortunately, the burden of proof is rather low in these cases. So, a little evidence about the nature of a voluntary pre-existing condition goes a long way. A few of these conditions are:
- Substance Abuse: A quarter of Americans admit they binge drink (five drinks in a day for men and four for women) at least once a year. The long-term effects of alcohol misuse are widely known. Roughly 10 percent of Americans admit they use illegal drugs or misuse prescription drugs. These effects are well-documented as well.
- Sedentary Lifestyle: People can exercise regularly and still live sedentary lives. An hour of exercise a day doesn’t make up for twenty-three hours a day of sitting. A sedentary lifestyle is closely associated with serious falls, which are a leading cause of SSDI applications. These individuals often have weak muscles and poor balance.
- Smoking: Despite all the information available, over 12 percent of people over 18 regularly smoke cigarettes or e-cigarettes. Smoking could cause multiple pre-existing conditions. Toxic smoke causes a number of serious illnesses, and people who are short of breath are more likely to hurt themselves. Nicotine levels tend to also be high in both cigarettes and e-cigarettes.
- Obesity: Worldwide, over a billion people are obese. The percentage of obese people is especially high in the United States. Basically, obese individuals are extremely overweight individuals who struggle with one or more weight-related health conditions. The extra weight also affects bones and joints.
Frequently, voluntary and involuntary pre-existing conditions overlap. For example, genetics usually has a lot to do with addictions to food, alcohol, and so on. This overlap is often a key component for Social Security disability lawyers who appeal SSDI applications that have been denied.
For more information about the social security disability claims process, contact the disability lawyers in Memphis at the Heermans Social Security Disability Law Firm. We work hard for you putting our trial experience and advocacy skills to use only for social security claimants! Heermans Disability also focuses on claimants who are appealing their SSD or SSI denials – specializing in preparation for hearings in front of administrative law judges. Use the Heermans FREE Disability Evaluation Form or contact us 24/7 via phone and text at (901) 244-0057. More value added FREE information can be found in our online article library.
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