You have reached this article because you applied for disability (or are thinking about it) and want to know whether you will be approved for benefits.
Unfortunately, the disability process is challenging, and it can seem like you are not getting anywhere. Indeed, the Social Security Administration (SSA) denies most disability claims at the initial level.
Your chances get better, however, if you appeal the initial denial. Recent SSA statistics indicate that award rates increase at the administrative hearing level.
Why am I telling you this? Because I want you to know that although no attorney can guarantee that the SSA will approve your disability claim, some factors point to a successful outcome. And knowing this can help you remain optimistic while fighting for your Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits.
This article details the top nine signs that indicate you will get approved for disability. Of course, every case is different, but these signs are a good starting place to gauge if your disability application might be successful.
However, it is not exhaustive. You may still qualify for disability even if you do not meet each of these criteria. But I recommend speaking with a disability attorney to discuss what you can do to improve your chances.
The SSA is one of the largest administrative agencies in the world, with thousands of employees. But you do not have to take it on alone. If you would like to speak with an experienced attorney, contact us today. Come see why past clients and other law firms have voted me as one of the best disability attorneys in Virginia.
The first sign that the SSA may approve your disability claim is earning less than the substantial gainful activity (SGA) level.
For 2022, the monthly SGA amount for non-blind applicants is $1,350.00, while the monthly SGA level for blind applicants is $2,260. Therefore, you can receive disability despite working – but only if your earnings are below this amount.
But there are a couple of things to remember about this sign.
First, earning less than SGA does not guarantee approval of your disability claim. You must still present evidence that your medical condition interferes with your ability to work and perform daily living activities.
Second, the SSA treats earnings and income differently. For example, workers compensation benefits (including a settlement), retirement pensions, and long-term disability payments do not count toward the SGA amount.
Third, monthly earnings exceeding SGA do not automatically disqualify you from receiving disability in specific situations. For example, you may still satisfy this requirement if you receive special accommodations when working or can deduct expenses for items to help you maintain employment.
You can learn more about substantial gainful activity here.
Social Security Disability is an insurance program. But instead of paying premiums as you do with auto insurance, you must earn work credits to have coverage.
You earn work credits when you pay Social Security taxes. For example, in 2022, you get one work credit for every $1,510 received in wages or self-employment income.
You can earn up to four work credits per year.
The SSA determines how many credits you need to qualify for disability benefits based on the age you allege you became disabled. Generally, you need to have at least 40 work credits, with 20 of those credits earned in the last ten years.
However, other work credits apply in particular situations. For example:
The Social Security regulations make it easier to get approved for disability as you get older. These regulations are called the Medical-Vocational Guidelines, or “Grid Rules,” for short.
For example, it becomes easier for many at age 50, then again for age 55, and again at age 60. If you are age 50 or older and have a severe medical impairment that keeps you from doing any job you have held in the past 15 years, you should apply.
Even if you are a younger person, you may still qualify for disability. You do not have to prove you are bedridden, only that you cannot do your past work or full-time employment.
You can learn more about age’s impact on disability approvals here.
The SSA publishes an online document titled Disability Evaluation Under Social Security, informally called the Blue Book because it had a blue cover when the SSA printed it.
The Blue Book lists medical conditions and impairments that the SSA considers severe enough to prevent someone from working regardless of age, education, and past work.
Having your medical condition listed in the Blue Book does not guarantee approval of your disability claim. But it is a start and helps significantly.
In addition to listing various conditions, the Blue Book describes the medical criteria you must prove to get approved for disability benefits. For example, it explains what symptoms you must have and test results (including diagnostic imaging) you need to qualify for disability from arthritis.
Other listings address medical diagnoses such as:
These are just a few examples. The complete list of qualifying conditions is available on the SSA website.
And remember, you can still win your claim even if you do not meet a listing. But meeting a listing increases the chance of being approved for disability benefits.
The SSA determines many claims based on medical evidence. Therefore, if you fail to submit medical documentation, there is little chance you will get approved.
We recommend submitting a flood of information and documents with your disability application. Then continuing to supplement the evidence as you continue to receive treatment.
You should submit the following medical records and reports to strengthen your disability case:
Further, I recommend asking your doctor to answer a questionnaire or complete a questionnaire that addresses any applicable impairment listing, your diagnosis, and your physical and mental work restrictions. I call this report a doctor’s disability letter.
The SSA is more likely to approve your disability claim based on a treating physician’s opinions if:
So do everything you can to treat as early as possible, especially if you have private health insurance or coverage through Medicaid, Tricare, or the Veterans Administration.
The SSA does not award temporary or partial disability. Instead, you must prove that your medical impairments have lasted or are expected to last for a consecutive 12-month period.
Therefore, evidence that you have been out of work for at least one year or that you have permanent restrictions that prevent you from returning to the job is critical to getting approved.
In addition, I recommend asking your treating physicians to write a letter stating how long your limitations will last.
Your testimony is critical to getting approved for disability. But it is rarely enough on its own. And it is not as powerful as actual examples.
You have a stronger disability claim if you can offer proof that you struggled the last few months that you did work or that your employer disciplined you (or terminated you) because you could not perform as expected. Indeed, a former employer’s letter or testimony that your performance declined as you got sicker puts you in a better position to win.
Similarly, evidence that you tried to return to work but failed because of your mental or physical impairments is credible if offered by a neutral third party.
The SSA may order a consultative exam before deciding your disability claim.
A consultative exam is a medical examination completed by a doctor with experience treating conditions such as those you allege disable you. The consultative exam doctor might be your treating physician; however, I find it more common for a doctor you have never seen or heard of before to do it. Indeed, the SSA usually orders a consultative exam when you have not provided opinion evidence or sufficient office visit notes from your treating physicians.
The consultative exam physician will write a report after the evaluation, stating whether they find you credible, what your diagnosis is (in their opinion), and stating your limitations.
If this doctor’s exam finds limitations that satisfy the SSA’s definition of disability, your claim for SSDI or SS is likely to be approved.
Finding a Social Security lawyer who will represent you is a good sign of getting approved for disability. Indeed, studies show that disability claimants with legal representation are nearly two to three times more likely to get approved.
There are several possible reasons for this.
First, most disability attorneys work on a contingent fee basis. You only pay a fee if you win. Therefore, disability lawyers usually only accept claims that have merit. Otherwise, they are wasting time and losing money.
Second, an attorney who focuses on helping a client get disability benefits from the SSA will ensure you have the most substantial medical and vocational evidence possible. The lawyer knows what you need and how to request it. And the deadlines for submitting documents or requesting subpoenas.
Third, an experienced disability advocate will know how the judge assigned to your case runs their courtroom. This knowledge will help you effectively present your case at the disability hearing (if one is needed).
Fourth, your legal representative will know how to cross-examination the vocational expert answering hypotheticals at your hearing. They will know which questions and limitations are likely to result in a finding you are disabled.
The statistics on disability approval can be discouraging.
But remember, millions of people receive them.
If you cannot work because of your health, do not be afraid to reach out for help.
As an attorney experienced in handling disability claims, I can help you maximize your chances of success with your disability application – either from the start or if your claim is denied and you need to appeal. I can even help if you need to refile for disability after being denied.
For all inquiries, please e-mail me at cpollardjba@gmail.com, call me at (804) 251-1620 or (757) 810-5614, or contact me online, and I will return your call as soon as possible.