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Proving a claim for Social Security Disability benefits

Most people in Missouri who have suffered a serious illness or injury that interferes with their ability to work have considered applying for Social Security Disability benefits. To a first-time claimant, the application process can seem confusing and intimidating. In this post we want to provide an overview of the information used by the Social Security Administration in evaluating SSD claims.

In order to obtain SSD benefits, a person must prove that he or she is totally disabled according to SSA's definition of the term. While a number of medical or mental conditions may cause disability, the claimant must prove that a specific injury or illness prevents him or her from working. The SSA federal regulations defines "disability" as the inability to engage in substantial gainful activity. This criterion is expressed in monetary terms: if a claimant is able to work and to earn more than $1,130 per month, he or she cannot be considered to be totally disabled. That criterion is explicit, but the others are not always so clear.

Proof of disability generally requires the opinion of a physician or other qualified professional that the illness or injury prevents the applicant from performing either his or her prior job or any other work. The SSA maintains extensive list of various "disabling condition." If a claimant's illness or injury is included in this list, the claimant is automatically deemed to be eligible for benefits. However, medical conditions are not on the list (or are on the list but with higher levels of disability or intensity), and the claimant in such a case must prove that his or her condition is equal in severity and disabling effect to one or more medical conditions on the list. Proving the existence of a disabling condition caused by a diagnosis that is not on this list can be daunting; at the very least, the opinion of one or more physicians or other health care provider will be required. A work history will also be necessary to document the claimant's inability to perform his or her job functions.

This blog cannot provide anything more than a cursory description of the evidence that is used to prove a disability claim. Anyone contemplating making an application for benefits should consult an attorney who specializes in pursuing such claims. A knowledgeable SSD claims attorney can assist an applicant in assembling the required information, including the necessary opinions from physicians and others.

Source: Social Security Administration, "Disability Planner," accessed on May 8, 2015

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