There are a number of steps you can take to improve your chances of being approved for Social Security disability benefits before you apply. The most important thing is that you know the disability requirements first. The basic requirement of Social Security disability is that you have a medical impairment or combination of impairments that will cause limitations for at least 12 months or the condition is expected to result in death. If you are under the age of 50, and your impairment (or impairments) must prevent you from performing all full-time work or must be serious enough that you qualify under a medical listing.
The majority of individuals that seek the assistance of an attorney do not qualify under medical listings. Instead they must be able to prove that their medical diagnosis causes limitations that will make it impossible to perform full-time work. If you are under the age of 50, it is not important whether you can perform your past work, just whether you are capable of performing any full-time work based on your limitations.
Generally, you are found to able to perform full-time work if you can stand for a total of at least 15 minutes of every hour during an eight hour work day (for a total of two hours in an eight hour workday), remain seated for a total of 45 minutes out of each hour for an eight hour workday, and have the ability to lift more than 3 pounds of weight on an occasional basis throughout the workday. If your impairment limits your ability to stand for less than a total of two hours during an eight hour workday, it is normally difficult to perform even sedentary work. Additionally, if your impairment causes frequent unscheduled breaks during an eight hour workday, or frequent absences on a weekly or monthly basis, most employers will not tolerate your loss of productivity. Vocational experts generally indicate that if an individual is unproductive for 15% or more of a workday, they are not employable.
For individuals age 50 or older, the disability standard is somewhat more lenient. You must still have a medical diagnosis that will result in limitations in the ability to perform work, but it is possible to be approved for benefits even if there are still jobs that you could perform on a full-time basis. If you are between the age of 50 and 54, and limited to a sit-down job that requires very little skills, generally you are found disabled unless you have performed similar jobs in the past. If you are age 55 or older, it is possible to be approved for benefits even if you can still perform jobs that require standing up six hours or more during an eight hour workday, and lifting up to 20 pounds on an occasional basis. The main question for individuals between the ages of 50 and 64 will be the type of work that they performed in the past, and whether the skills that you have learned from the past work will transfer to easier work. If an individual age 55 and older is only able to perform work with lifting restrictions of less than 20 pounds, and has no transferable skills to work that is consistent with their remaining abilities, generally they will be found disabled.
Before applying for benefits it is a was important that all individuals have treatment for their condition. If you are suffering from an impairment, it is important that it is diagnosed. Simply having aches and pains without a medical diagnosis is generally not sufficient. Social Security considers all physical and mental conditions when determining your disability. If you are experiencing any medical problems, it is in your best interest to discuss those with a doctor and to follow your doctor’s treatment suggestions. Even if you did not stop working as a result of medical condition that you are suffering from, it is important that you have treatment for these conditions and that you disclose your condition to the Social Security Administration.
While pursuing treatment for your condition, it is important that you see specialists for confirmation of your diagnosis, and to obtain suggestions for improvement of your condition. Often, I am unable to offer my assistance to individuals because they have not received sufficient care for their condition. If you are suffering from back pain, arthritis, depression, or any other condition that is preventing you from performing work, it is normally important that you see a specialist for your condition. If there are objective tests to determine if your condition exists, Social Security will normally expect that those tests be performed prior to your application. If your doctor prescribes medications, it is important that you take your medications as prescribed. Failure to follow or comply with your doctor’s instructions can result in a denial for benefits. If you have difficulty following your doctor’s instructions, it is important that you speak with your doctor concerning the difficulties.
For individuals that do not have medical insurance, it is possible to receive treatment through clinics. In Delaware, there are several different low cost physical and mental health clinics that are available. These clinics usually see patients on a sliding scale basis. Information will be asked about your resources and income and the clinics will determine the most that you can pay for the services that are available. Often these clinics are able to provide services to low income individuals free of charge. If you have limited income and resources it is also important that you apply for medical assistance through the state that you live in. If you are below the poverty level, you often will qualify for free medical care through the state you live in. The Medicaid program in the State of Delaware provides better coverage than the majority of health care plans that individuals can purchase on their own. Generally, with Medicaid in Delaware, all doctor and hospital visits are free of charge. Transportation is available at a low cost, and prescriptions are normally less than five dollars.
When you apply for disability benefits, Social Security considers your medical condition and also information that you provide them. It is important that Social Security finds you to be a credible person when you apply for benefits. Social Security looks for inconsistencies in the statements that you provide, and inconsistencies between your statements and statements in your physician’s reports. The use of illegal substances, or the abuse of alcohol can cause problems for you during your application. If your use of illegal substances or alcohol is material to your condition, even if you are disabled, Social Security will deny you benefits. Even if your use of illegal substances or abuse of alcohol does not contribute to your condition, it can still be used as a factor in determining your credibility. If you are using illegal substances, you are breaking the law, and this is a relevant factor when determining if you are believable. Even if you do not disclose information about your use of alcohol or illegal substances, normally this information is found through your medical records.
You cannot begin your application for disability benefits until you are out of work, or your earnings from work have been reduced to a point that you are making less than $980 per month (this is the maximum you can make and still apply for benefits in 2009). Although you can apply for benefits the first day after your employment ends (or your earnings are reduced below the allowable limit), I normally recommend that individuals wait to apply until sufficient proof of their disability is available. Since Social Security must be convinced that your condition will prevent you from returning to work for at least 12 months, or result in death, it is often hard for individuals to be approved if they apply for benefits shortly after employment has ended.
The exception is if you have been diagnosed with a terminal illness. When you have been diagnosed with a terminal illness, it is important to apply as soon as possible. When you apply for a condition that may improve, commonly the Social Security Administration will deny your application even if you are currently disabled. It may be determined that even though you are currently unable to work, your condition is expected to improve within 12 months. Before applying for benefits, I suggest that my clients discuss their options with their treating physicians, make sure that their treating physicians are supportive of their application, and also discuss the expected duration that their condition will prevent them from working. If it is unknown if the condition will result in the inability to work for at least 12 months, I normally suggest waiting to apply until closer to the 12 month mark.
It is always important that you communicate with your physicians throughout this process. You should find out if your doctors are going to support your application for disability, and whether they will be willing to provide information that is necessary to help you be approved. I also commonly ask that my clients have forms completed by their doctors before filing an application for benefits. This gives me a better idea of what your doctor thinks, and allows me to better determine if you have a condition that meets the disability requirements. It is important to communicate with your physicians that you would prefer to work, and that you are only pursuing disability benefits because that is your only option based on your limitations. I always encourage my clients to remind their doctors that they are willing to take any steps necessary to allow them to return to productive work in the future.
Even when everything is done properly for an application for disability benefits, it is a time-consuming process. The average time for a decision in Delaware is between 4 to 7 months on the initial application. Failure to provide all of the needed information to the Social Security Administration can result in delays, and failure to seek necessary treatment can result in a denial. If you are considering applying for disability benefits, I recommend that you contact my office for assistance at the earliest possible time. Although it is possible to pursue disability benefits without the help of an attorney, it is helpful to have an experienced person help navigate you through the process. Please contact my office if you would like a free initial consultation.
Relevant links:
- Social Security Listing of Impairments
- Delaware Medicaid Frequently Asked Questions
- Delaware Low Costs Healthcare Clinics
- Delaware Online Public Assistance/Medical Assistance Application
This article was written by Steven Butler. Steven is a partner at Linarducci & Butler, PA and his practice is limited to Social Security Disability/SSI claims. Steven offers free initial consultations for Social Security Disability/SSI claims to residents of Delaware, Maryland, New Jersey and Pennsylvania. To schedule a consultation with Steven, please use the Linarducci & Butler Contact Form or call 302-613-0707 to schedule an appointment.