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Columbia MO Social Security Disability Law Blog

Do I need a lawyer to get SSD benefits?

For most people in Missouri, the process of applying for and obtaining Social Security Disability Insurance (SSDI) benefits can seem more than a little intimidating. A common question that potential applicants ask is whether they need a lawyer to get them through the SSD claim process. The answer depends in large part upon the nature of the process itself.

The Social Security Administration publishes pamphlets and information sheets that explain the SSDI claim process. These documents are also available on the SSA web site. In fact, many claims can be filed online. So where does a lawyer come in?

Amputations and Social security disability benefits

for injury

For most Missourians, the loss of a limb is one of life's most feared injuries. Even with the advances in the technology of prosthetic limbs, the prospect of losing a hand or a foot (or worse) is genuinely terrifying. Nonetheless, the regulations for Social Security Disability claims do not provide benefits for every kind of amputation. In this post, we will summarize the Social Security Administration requirements for obtaining SSDI benefits for an amputation.

What are some qualifying mental conditions for SSDI benefits?

Many Missourians suffer from a mental disorder or illness. Some of these diseases, if they are severe, can interfere with a person's ability to work. In such cases, the illness may support a successful claim for Social Security Disability Insurance ("SSDI") benefits. In this post, we will provide an overview of the mental illnesses and symptoms that may qualify for SSDI benefits.

As with most diseases, the Social Security Administration requires documentation of a medically provable mental impairment, verification of the disease's limitation on a person's ability to work, and proof that the condition will last or has lasted for 12 months. The specific diseases are arranged in nine diagnostic categories: organic mental disorders; schizophrenic, paranoid and other psychotic disorders; affective disorders; intellectual disabilities; anxiety-related disorders; somatoform disorders; personality disorders; substance addiction disorders; and autistic disorders and other pervasive developmental disorders.

How does the "Blue Book" affect a claim for SSD benefits?

Most Missourians who are contemplating a claim for Social Security Disability Insurance benefits are aware that they must prove they suffer from an illness or injury that prevents them from working. Some may also be aware that the Social Security Administration has adopted regulations that guide its decisions on SSD claims.

The compilation of regulations defining qualifying medical conditions is called the "Blue Book," and it contains detailed descriptions of those injuries and illnesses that qualify for disability benefits. If an applicant for benefits can demonstrate that he or she suffer from one or more of the conditions described in the Blue Book, and that the condition precludes them from substantial gainful employment, his or her claim will likely be approved within a few months or sooner (assuming the claimant also satisfies the non-medical eligibility requirements).

SSDI benefits for liver disease

Social Security Disability Insurance ("SSDI") provides benefits to Missourians for a number of diseases and conditions that affect the digestive system. In this post, we will focus on diseases of the liver.

SSDI benefits are available for eight separate liver conditions: hemorrhaging, accumulation of fluids in the abdominal cavity, bacterial peritonitis, hepatorenal syndrome, hepatopulmonary syndrome, hepatic encephalopathy and end stage liver disease. The SSA Red Book establishes laboratory benchmarks that are used in evaluating the seriousness of the disease or condition. As with any of the diseases in the Red Book, the SSD claim must be supported by medical evaluations and laboratory test results. If the objective medical evidence satisfies the prescribed thresholds, the benefits application will most likely be approved.

SSDI benefits for drug addiction and alcoholism

In Missouri and many other states, alcoholism and drug addiction afflict thousands of people. Each condition is considered to be a disease, with well-established diagnostic criteria and treatment regimens. In this post, we will discuss the extent to which persons suffering from either of these two diseases may be eligible for Social Security Disability Insurance ("SSDI") benefits.

The Social Security Administration's list of qualifying conditions places alcoholism and drug addiction under the category "substance addiction disorders." A substance addiction disorder is a condition that causes "[b]ehavioral changes or physical changes associated with the regular use of substances that affect the central nervous system." The severity of the illness must be evaluated according to the criteria that are specified for other mental disorders, including organic mental disorders, depressive syndrome, anxiety disorders, personality disorders, peripheral neuropathies, liver damage, gastritis, pancreatitis and seizures.

Understanding qualifying medical conditions for disability

In general, disabled individuals suffering with a disability that prevents them from working may qualify for disability benefits. The Social Security Administration provides a list of medical conditions that automatically qualify an individual for disability benefits provided certain other conditions to qualify for benefits are also met. In circumstances when an individual suffers from a disability not on the list, it may still be possible to obtain Social Security disability (SSD) benefits.

For adults suffering from a disability, the categories of medical conditions include musculoskeletal problems; sense or speech problems; respiratory illnesses; cardiovascular conditions; digestive tract problems; neurological disorders; blood disorders; and immune system disorders. In circumstances when the disabled applicant suffers from a medical condition that is not on the list, they may still be eligible for benefits if they have a medical condition that can be confirmed clinically and through laboratory testing. A variety of different types of tests and medical records can be used to establish disability.

How does SSA evaluate a claim for disability benefits?

To residents in Missouri and elsewhere, the evaluation of a claim for Social Security Disability Insurance or SSDI benefits often appears to be an opaque process performed behind closed doors by anonymous bureaucrats. In fact, the process for evaluating an SSDI application is guided by explicit standards that must be followed by all SSA employees who are involved in assessing SSD claims.

The process comprises two separate inquiries. First, is the applicant prevented by an injury or illness from working, and second, does the applicant satisfy the non-medical eligibility requirements? The non-medical eligibility requirements are evaluated by the field office that receives the application. The information includes age, marital status and Social Security coverage information.

What happens at an SSDI hearing?

We have written in other posts about the Social Security Disability Insurance or SSDI claims and appeals process. The SSD appeals process includes several steps, including the initiating request for reconsideration. By far, the most important step is the hearing before an administrative law judge. In this post, we will focus on what happens in one of these hearings.

An appeals hearing is the presentation of written evidence and oral testimony to a hearing officer, called an administrative law judge or ALJ, who has been specially trained to hear and resolve cases involving the denial of an application for disability benefits. A hearing must be requested in writing, either online or by mailing in the necessary forms. The hearing will usually be scheduled to occur in a place not less than 75 miles of the applicant's home. If the applicant is unable to travel, the hearing may take place via video teleconferencing.

What is a residual functional capacity assessment?

Residents in Missouri who apply for Social Security Disability Insurance or SSDI benefits will ikely be required to submit to a "residual functional capacity assessment." In this post, we will explain the nature of a functional capacity assessment and show how it affects a person's chances of receiving SSDI benefits.

The medical evidence that accompanies an initial SSD claim for benefits may not completely answer certain questions concerning the nature and extent of the applicant's qualifying illness or injury. A residual functional capacity assessment is then used to obtain more information about how the illness or injury affects the applicant's ability to work.

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