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What is Considered a Disabling Condition?

You have a condition or illness that prevents you from earning a full-time income and you’ve been told by friends, family and maybe even a doctor or caseworker, that you should apply for Social Security Disability benefits (SSDI and/or SSI).

However, you’ve heard that it can be an arduous process and that it’s not easy to get approval.  So, how do you know if your particular circumstance even qualifies for benefits?

Before you begin filling out an application, there are a few things to consider when it comes to your disabling condition.

3 Keys to Qualifying Conditions

To begin, there are three main questions to ask yourself about your disabling condition. Answering these may help you figure out exactly what is considered an impairment that could qualify for SSDI or SSI benefits.

1. Is your disabling condition listed on the Social Security Administration’s (SSA) Listing of Impairments?

Also known as the Blue Book, this comprehensive list is split into two sections.  One is for adults and the other is for children 18 years and younger.  If your condition is listed in the Blue Book, you may be eligible for SSDI or SSI benefits.

Please note that the impairments listed in the Blue Book are not the only ones that are approved by the SSA.  

If you have an impairment listed but do not meet the exact criteria OR if you have an impairment that is not exactly the same, but similar to one listed, you may still be able to qualify.  Be prepared to make your case to SSA as to how and why your impairments are as limiting as the ones on the list.

2.  Is your disability long-term?  

SSDI and SSI benefits are not meant for short-term impairments no matter how limiting they might be.  Your condition will only be approved if it has already lasted or is expected to last 12 months or longer (or expected to end in death).

3.  If you are under the age of 50, do your medical conditions prevent you from successfully performing any type of full-time work?  If you are over 50, do they significantly limit your ability to stand and lift?

The answer to this may seem subjective, but if you feel that your condition prevents or limits your ability to work full-time, you will have the opportunity to make your case using medical records.  It is imperative that you always tell your medical professionals about all of your symptoms and limitations so that they may record them.

I Think My Condition Would Qualify for Benefits. Do I Apply For SSDI and SSI Benefits?

Now that you have answered these three key questions and analyzed your responses, you might be thinking that your condition may qualify for SSDI and/or SSI benefits.  The next step is to begin the application process.

  • OK, so HOW do I apply for SSDI and SSI disability benefits?  There are many free resources available to walk you through the application process.  Speaking to a lawyer that knows SSDI and SSI law may be beneficial.
  • Worried About Making a Mistake With Your Application? Download our FREE GUIDE “Common Mistakes People Make When Applying for Disability” to help you navigate the application process and to give you a head start on avoiding any simple mistakes.
  • I’m Still Not Sure If My Condition Qualifies.  How Do I Find Out More?

You may not have cut-and-dry answers to the three questions listed.  Now you are still unsure and don’t know where to go for answers.

Speaking to an experienced professional, like an attorney, may be the next step.  They can help you decide if pursuing SSDI and/or SSI benefits is worth your time and energy.  Additionally, they may even be able to help you with the application or appeals process.

To speak with the experienced team at Roose & Ressler about your impairment and application, contact us today.  A consultation is no cost to you and may be valuable in helping you determine whether or not your condition will qualify for benefits.

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An attorney can give you the best possible chance that your claim will be approved. Sometimes the process is confusing or complicated. An attorney can explain what is happening and can ease your mind when there is nothing to be concerned about and take action for you when there is a concern. An attorney can be your partner, walking through the process with you, from beginning to end, including making sure that you are paid all the benefits to which you are entitled when you win.

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COVID-19

Since the COVID-19 pandemic remains a threat to our clients and staff, in-person meetings continue to be on hold. Roose & Ressler continues to conduct our work by telephone, e-mail, mail, and by videoconferencing.  We are maintaining sanitized space, and require face coverings when in-person contacts are needed. Even though some staff are working in our offices at some locations, we ask that you call ahead, so that we are ready for you. All staff in our Toledo location continue to work from home, but we can arrange for documents to be dropped off and to meet you for necessary in-person contacts.

Social Security’s offices, including the hearing offices, remain closed for most purposes.  Disability hearings have been held by telephone conferences since April 2020.  Social Security is rolling out a video-conferencing hearing option in which all parties can appear from separate locations using the Microsoft Teams platform.

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Does Cheating Explain a Decline in Applications for Disability Benefits?

The Washington Examiner recently published an article with the headline, “Hurrah, There are fewer disabled and fewer cheats.”  It offered an explanation for the sustained drop in applicants for Social Security disability and SSI benefits and a decline in the total number of people receiving disability benefits (www.nytimes.com/2018/06/19/business/economy/social-security-applications.html).  According to the author, this welcome news reflects a “moral problem,” that many applicants and beneficiaries are frauds.   The reasoning goes that the reduction in applicants and beneficiaries is largely due to a strengthening economy.  And since there should be no connection between the strength of the economy and how many people are disabled, it can be deduced that “the system is rife with abuse by people who can work but would rather defraud the system than get off the sofa.”  I submit that the conclusion is too simplistic.

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Social Security Has Insufficient Staff to Manage Backlog

By Jon Ressler, Attorney, Roose & Ressler

I wrote last December about the Social Security disability backlog, highlighting the fact that the average wait for a hearing had grown to over 600 days and that a primary driver of the increasing backlog was insufficient funding. Another recent article at investmentnews.com/article/201803… describes the impact of insufficient funding on other Social Security services.

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Does SSA Care If Your Doctor Thinks You Are Disabled?

By Jon Ressler, Attorney, Roose & Ressler

For well over 20 years, Social Security acknowledged that your treating doctor has unique insight in assessing your medically-caused functional limitations. Not anymore.

If you filed a Social Security disability application since March 27, 2017, the voice of your treating doctor is now just one among many. Social Security adopted new rules about how it will weigh opinions from medical sources. This change will make proving disability more difficult in many cases and is likely to result in increased denials for claimants with genuine disability.

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Winning Your Disability Case by Combining Impairments

People who apply for Social Security disability have severely disabling conditions, which, unfortunately, do not automatically qualify them for benefits under the Social Security Disability rules.

Social Security Administration lists a number of impairments that automatically qualify an applicant for disability benefits. Most of these require very specific medical or laboratory findings. If your medical evidence meets the requirements of an impairment listing, you will automatically be found disabled. However, even if you do not meet the detailed criteria of a listed impairment, you may still qualify for Social Security disability benefits if your symptoms and diagnosis are “medically equivalent” (i.e. equal in severity) to the listed impairment may have a condition which is not found in the listed impairments but is equally severe in its debilitating effect. Or you may have a combination of impairments which are found on the list but lack one or more of the detailed criteria to qualify you under the Rules for disability; added together, though, they are medically equivalent to the listed impairments.

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The Order in Which Things Happen at the Hearing

What happens in the hearing room? Most judges commence Social Security disability hearings by recounting the “case history” of the disability claim and reciting the issues to be decided.

Although judges often recite what a claimant needs to prove in order to prove the case, they rarely give a well-defined and simple explanation. Rather, they usually state that the claimant must be “unable to perform substantial gainful activity which exists in significant numbers in the economy, considering your age, education and work experience.” Such a statement may give the claimant the false notion that they have to be bedridden to get disability benefits. This is the precise reason why you should seek the assistance of an Ohio disability lawyer.

The judge may question the claimant first and then give his or her disability lawyer the option to ask questions. Sometimes, if a claimant is well prepared to testify, the lawyer does not need to ask any questions.

Some judges may expect lawyers to do most of the questioning. If this is the case, the claimant should answer the lawyer’s questions with the utmost detail, as if talking to a stranger. The claimant should refrain from responding in incomplete answers simply because his or her lawyer already knows a lot about the case. Even though the judge may have read the file prior to the hearing, the claimant should assume that the judge knows very little about the case. As such, the claimant should give details, details, details.

So if you have been denied Social Security disability benefits, please fill out the claim evaluation form on this page to contact Ohio disability lawyers Roose & Ressler.

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How Does the Social Security Administration Define a Disability?

The Social Security Administration has specific requirements for finding that a claimant disabled. For advice on whether you may be considered disabled, call your Ohio Social Security disability attorney to discuss your claim.

To be found disabled, a claimant must have a medically determinable impairment. A medically determinable impairment is a physical or mental impairment that results from anatomical, physiological, or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques. The claimant’s age, education and work experience must be taken into account. The impairment must meet the following requirements:

Duration. The impairment must be expected to result in the claimant’s death or it must have already lasted or can be expected to last for a continuous period of not less than 12 months.
Past Work. The impairment must prevent the claimant from performing any past relevant work.
Future Work. The impairment must prevent the claimant from performing any other substantial gainful work that exists in the economy in significant numbers.

The Social Security Act expressly states that a claimant is not disabled if drug addiction or alcoholism is a material contributing factor to the individual’s impairment.

The Supplemental Security Income program applies this same definition of disability. This program provides a minimum income level to disabled people who do not qualify for Social Security disability benefits.

For advice on whether you may be considered disabled, call Ohio Social Security disability attorneys at Roose & Ressler to discuss your claim.

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Why are more Americans receiving Social Security disability insurance benefits?

You hear a lot of talk about this. But the reasons are logical and not mysterious. It is certainly not because people don’t want to work any more.

The baby-boomers have reached the age where disability is more likely. This is just a bulge in the population that was expected.

More women have earned enough work credits to qualify for this program. Before, they would be disabled but the SSI disability program or their families would support them.

The full-retirement age for Social Security increased from 65 to 66. So people who already get Social Security disability at age 65 stay on it for another year until age 66, instead of their checks being renamed “retirement.” And people who become disabled between their 65th and 66th birthdays will have to try to get “disability” checks instead of “retirement” checks, and now have to prove disability and lose a 5-month waiting period.

Other public or private programs have been cut back, so disabled people who were hidden in those programs now have to qualify for Social Security disability. Welfare, unemployment, pensions, and many other benefits have been scaled back, not fully protecting people who are affected by the recession.

For more, take a look at the testimony of Social Security’s chief actuary, the person who is supposed to figure this out: http://www.ssa.gov/legislation/testimony_120211.html
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Factors Our Toledo Social Security Attorney Looks for in an Appeal

When our Toledo Social Security attorney considers a case for appeal to federal court, there are several factors that the lawyer will assess. Here is a short list that he or she may consider.

Presence of Disability

Before a Toledo Social Security attorney files a case in federal court, he or she will begin an assessment of the case just as he or she would if the case was going in front of an administrative law judge. He or she will go through the sequential evaluation and consider multiple theories about why the claimant is disabled. If the appeal is successful, the case will likely be sent back for a new hearing in front of an administrative law judge in which the attorney will have to convince the judge that the claimant meets the definition of being disabled.

Legal Errors

The Toledo Social Security attorney will have to articulate why the administrative law judge’s decision is erroneous. As such, he or she will look at the evidence that the judge cited in his or her ruling. The lawyer will see if there is contradictory information in the judge’s opinion or if there is inadequate information that is cited as evidence in the opinion. Successfully making this argument requires the Social Security disability attorney to be familiar with Social Security rulings and regulations. By showing that the administrative law judge deviated from precedent, the lawyer is more likely to be successful than if he or she claims that the judge erred by not showing that there was substantial evidence to support his or her decision. Additionally, the lawyer must be able to show that the error that the administrative law judge caused him or her to make the erroneous decision. Simply because the judge did not apply a law correctly does not mean that the lawyer will succeed in the appeal. Instead, the lawyer must show that had the administrative law judge not made the mistake, he or she would have reached a different decision.

Compelling Facts

Although it is not essential that there be compelling facts or a claimant who is sympathetic, these factors can assist the Social Security attorney.
Legal Assistance from a Toledo Social Security Attorney

If you would like to know if any of these factors are present in your case, a Toledo Social Security attorney may be able to help. Contact Roose & Ressler at (800) 448-4211.

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Media

To members of the media, if you need expert information, insight or background research for a story you are working on regarding Social Security Disability Benefits and other factors related to Social Security legal issues, please contact our media relations firm at 440-695-0817 or email RRoeser@TheEisenAgency.com to set up an interview or call.

Speaking Engagements

To organizers of business events and seminars, our legal team looks forward to sharing insights and educational expertise regarding issues of Social Security Disability Law that affect Ohioans and other issues related to Social Security. If you need an educational speaker for an upcoming event, please fill out the following form: