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Columbia MO Social Security Disability Law Blog

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.

How does the Social Security Act define "disability"?

Many Missourians who are contemplating filing a claim for disability benefits under the Social Security Act will want to know and understand how the statute defines "disability." In this post, we will review the statutory language and explain how the Social Security Administration or SSA uses the language in evaluating SSD claims.

In order to receive SSD benefits, a person must be permanently and totally unable to work. No benefits are payable for a partial or temporary disability. The term "totally disabled" means that the applicant must be unable to engage in "substantial gainful activity" for a period of at least one year. Substantial gainful activity is measured by a person's annual wages from work. In 2016, a person who earns less than $1,130 per month is considered to be totally disabled.

What is Supplemental Security Income?

The Social Security Administration or SSA administers a number of programs intended to assist Missourians who are disabled or financially impoverished. One of the most used programs is called Supplemental Security Income or SSI, but few people understand how the program works.

A person making a claim for SSI benefits must provide information about the qualifying condition, such as age, blindness or disability and their income and assets. The following groups of persons are eligible for SSI benefits if they have income less than the maximum prescribed by SSA regulations: age 65 or older, blind or disabled.

Understanding the Social Security disability appeals process

Understanding the Social Security disability appeals process is important for disabled individuals and their families who rely on resources made available to those suffering with a disability that results in an inability to work. In general, Social Security disability (SSD) benefits are available to individuals suffering from a medical condition that lasts longer than 12 months, or is expected to result in death, which renders them unable to work or perform gainful activity. In addition, to qualify for SSD benefits, the disabled individual must meet the work history requirement, however, additional options, such as Supplemental Security Income, may be available to disabled individuals who do not meet the work history requirement.

A large number of applications for Social Security disability benefits are initially denied. Following a denial, the applicant has 60 days to make an appeal so it is important to promptly respond to a denial of a claim for benefits. There are generally 4 steps in the appeals process. The first step is the reconsideration process. During the reconsideration process, a party not involved in the initial review of the claim for benefits reviews the entire application again. New evidence may also be submitted at this time so it is important to have complete medical records to provide.

Is epilepsy a qualifying disease for disability benefits?

Epilepsy afflicts many people in Missouri. The seizures that typify the disease can interfere with work and with the daily tasks of living. Most people familiar with the disease understand that it has varying degrees of intensity, and the Social Security Administration takes these differences into account in defining the level of disability that qualifies for Social Security disability benefits.

In evaluating SSD claims for benefits based on epilepsy, the SSA looks at the type, duration and frequency of seizures. The applicant must furnish at least one detailed description of a seizure, including the presence or absence of an aura, tongue biting, sphincter control, injuries suffered in the attack and post-seizure symptoms such as drowsiness, confusion, nausea and headaches. The treating physician should submit a statement describing the extent to which the applicant's subjective description of symptoms is consistent with his or her own observations. A very important condition of eligibility for benefits requires that the applicant follow prescribed epileptic treatment. Blood tests are often used to determine the level of anti-epileptic medication in the applicant's blood stream.

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