When is a Medical Condition “Severe” for Disability Eligibility

Social Security looks at your severe medical conditions in deciding your disability claim.  Deciding what conditions are severe is step two of the five step disability process. Over time Social Security has changed its view on what counts as severe.  Now the rule is almost a formality.  If a medical condition has even a minimal affect on your ability to work it counts as severe.

In reality Social Security considers nearly all of your medical conditions when deciding your case.  Still, some medical conditions don’t meet the severity requirement.  For example, you might have high cholesterol, high blood pressure, or hyperlipidemia.  These conditions can cause severe problems over time, but you might have them under control through diet and medication.

The severity requirement still has a role in the disability determination process.  That role is to simplify your case.  Remember that Social Security decides which of your medical conditions are severe at step two of the five step process.  By taking out conditions that don’t affect your ability to work, the severity rule makes Social Security’s job easier at steps three, four, and five.

Some disability judges still use the severity requirement to deny disability claims.  This allows them to make a quick decision without looking at whether your case meets a disability listing or whether you can do your past work or other work.  If a judge denies your case by deciding your conditions are not severe then it is frequently not hard to get that decision reversed on appeal.

Posted in Basics of SSD, Legal Concepts in SSD, Questions & Answers, Severe Impairments (Step 2) | Comments Off on When is a Medical Condition “Severe” for Disability Eligibility

Physical Disabilities That Could Make One Eligible for Disability Benefits

The US Social Security Administration (SSA) offers disability benefits to provide monthly monetary assistance to individuals suffering from a disability under two key programs, the Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) programs.

SSDI is a monthly payment for individuals who have worked earlier, have paid into Social Security by paying taxes as required, and are now unable to work for at least a year or more due to their disability.

The SSI program offers monthly payments to the disabled regardless of their previous employment history.  Eligibility for this program is based on income levels.

Eligibility Criteria

The rules SSA uses in determining if someone is disabled or not are the same under both programs, but some people can qualify for just one or both, based on the above criteria.  By definition, a person will be considered disabled if he/she has a residual functional capacity that is so reduced due to a medical condition’s limitations that the claimant is unable to work.  Such medical impairments must either be terminal or be expected to remain for at least 12 months.

Key Physical Disabilities

There are a vast number of physical disabilities that come under the gamut of eligibility criteria for the Social Security disability program.

The following are some, not all, physical disabilities in broad categories:

1) Visual disabilities – This category of disability will generally require treatment. Visual impairments include:

i)             Blurred vision

ii)           Blindness

iii)          Cataract

iv)          Color blindness

2) Auto-immune disorders – This category of disorders generally bring the entire body mechanism under an attack and can consequently cause a severe degree of physical damage.  The main auto-immune disorders are:

i)             Systemic Lupus Erythmatosus

ii)           Multiple Sclerosis

3) Hearing-related impairments – By impairing an individual’s capacity to hear, these impairments limit a person’s ability to function professionally and to some extent, perform daily life activities.

i)             Meniere’s Disease

ii)           Hearing Loss

iii)          Tinnitus

iv)          Inner ear problems

4) Mobility impairment – These disabilities can either be present at birth or can be gradually acquired by the effected person.

i)             Multiple sclerosis

ii)           Parkinson’s disease

iii)          Duchenne muscular dystrophy

iv)          Stroke

v)           Cerebral Palsy

vi)          Arthritis

5) Chronic disorders – These are long-term chronic illnesses that are quite often fatal in nature and often make an applicant eligible for Social Security Disability benefits. The main disorders could include:

i)             Cancer

ii)           Asthma

iii)          Diabetes

iv)          Hypoglycemia

v)           HIV Aids

vi)          Tuberculosis

vii)        Renal Failure

5) Other disorders – These impairments are usually classified as physical disabilities, and when present at a severe level they often prevent the claimant from working.  These impairments can often make a claimant eligible for disability benefits.

i)             Alzheimer’s

ii)           Chronic Fatigue Syndrome

iii)          Hepatitis

iv)          Bronchitis

v)           Cystic Fibrosis

vi)          Joint problems

vii)        Repetitive Stress Injury (RSI)

viii)       Headaches/Migraines

ix)          Seizures

x)           Fibromyalgia

Conclusion

The above-named conditions cover many conditions but these are not all possible conditions, there are certainly others that can also be physical impairments that would make someone disabled.  Not everyone with a severe impairment is going to be declared disabled and eligible for benefits under the SSDI and SSI programs, but if your condition meets the required levels you could be eligible.

Posted in Disabling Conditions, Winning Disability Benefits | 3 Comments

What is the DOT that the VE referred to?

DOT stands for “Dictionary of Occupational Titles”.  The DOT is a government survey by the Department of Labor, who created it to provide job information to government agencies, job seekers, and educational and training institutions.  The DOT contains over 12,000 job descriptions.  Each description gives an estimate of the mental and physical demands, skills, traits, and length of training needed for that particular job.

The last updates to the DOT were made in 1991 and the DOT is considered to be obsolete, even by the Social Security Administration.  Social Security is making an effort to find a replacement, but has made little progress so far.  The DOT continues to play a major role in how Social Security decides disability claims.

The jobs experts that testify in disability hearings are called Vocational Experts or “VEs”.  VEs use the DOT for three purposes: (1) to categorize the work you have done, (2) to determine if skills from your past work could be transferred to other work, and (3) to answer judges’ questions about other work you might be able to do.

Social Security regulations require that disability judges ask the vocational expert if their testimony is consistent with the DOT.  VEs are allowed to give testimony that differs from the DOT, but they must explain why they disagree with it.  Usually VEs just follow the DOT, but some will add information gained from their own experience studying jobs or helping place individuals into jobs.

If the VE’s testimony suggests you can work then the judge must be persuaded that the VE is wrong.  The simplest way to do this is to show that the VE’s testimony doesn’t match with the information in the DOT.  Even though VEs bring copies of the DOT into the hearing, they still sometimes make statements that are just plain wrong under the DOT.  In order to make this kind of attack you need to bring a copy of the DOT to the hearing and know how to use it.  Many disability attorneys and VEs use laptop computers to access DOT information quickly during the hearing.

Some job descriptions in the DOT date back to 1977.  Pointing out how the DOT has failed to keep up with reality can persuade a judge to reject VE testimony.  Also, you can submit other documentation to show that the DOT job description is now outdated.  You can get written descriptions of the job requirements from actual employers.  You can also submit job descriptions from other publications accepted by Social Security.  There are three officially recognized sources other than the DOT: the Occupational Outlook Handbook, County Business Patterns, and the Selected Characteristics of Occupations.

Posted in Capability to Work (Step 5), Past Relevant Work (Step 4), Vocational or Work Issues | 2 Comments

What is Past Relevant Work (PRW)?

If SSA decides you do not meet a listing, then your case proceeds on to step four of the five-step disability evaluation process.  At step four Social Security considers whether you can return to your Past Relevant Work, or “PRW” for short.

Social Security will ask you for details about your past work at the very beginning of your case.  Those questions may seem simple enough, but they aren’t.  Social Security will look closely at your answers at every stage of your case.  Make sure that your answers are completely accurate.  Don’t overstate your job responsibilities or your authority over other workers.  The more skilled your work was the harder it will be to win your case.

Social Security has a three-part test for what work is considered Past Relevant Work.  Your past jobs must meet each of the three requirements to be considered PRW.  First, you must have done the work in the past 15 years.  This simple rule applies in all cases unless you have an expired Date Last Insured.

Your past work is not PRW unless it was “Substantial Gainful Activity”.  This means that your gross earnings from the job were under the amount set by Social Security.  In 2010 that amount was $1,000 per month.

Finally, your past work is not PRW unless it lasted long enough for you to learn how to do it.  Jobs that lasted less than three months are rarely considered PRW.  Of course, more complex jobs take longer to learn.  Disability judges rely on the Dictionary of Occupational Titles, a Labor Department job survey, for an estimate of how long it should have taken you to learn your past work.

Posted in Legal Concepts in SSD, Past Relevant Work (Step 4), Vocational or Work Issues, Why People Are Denied, Your Limitations | Comments Off on What is Past Relevant Work (PRW)?