If you’re applying for Social Security Disability Insurance, or SSDI, you may wonder what the magic formula is to ensure your application will be accepted. Unfortunately, SSDI approvals are never guaranteed. Approvals and denials often come down to the opinion of the Social Security Administration agent handling a given case.
The majority of first-time applicants—roughly 67 percent—are denied on the first try. Even the most sympathetic case may need to go to a hearing before an administrative law judge before the claimant is approved.
However, certain factors can add up to a strong case for receiving SSDI. These factors do not guarantee a specific result but may improve your approval odds.
You Have Enough Work Credits
SSDI provides benefits to those with a disabling condition that prevents them from working. To qualify, an applicant must have paid enough tax into Social Security during their lifetime to have become “insured” by the SSDI program. Regardless of the extent of your disability, you must have enough Social Security work credits to receive approval for SSDI benefits. You must also have earned a certain number of those credits within your recent work history.
The number of work credits needed to qualify depends on your age when you became disabled. For example, if you became disabled before you turned 28, you must have accrued six work credits during your lifetime. However, if your disability began at age 50, you need 28. The time it takes to earn the required work credits varies based on how many you earn each year. If you earn the full four credits every year, you’ll reach your eligibility level in the shortest time possible.
Strong Medical Documentation
One of the most common reasons the Social Security Administration denies SSDI claims is the lack of sufficient medical evidence. Strong medical documentation of your disability from a doctor or other medical expert goes a long way in proving that your disability is legitimate and prevents you from working.
Generally, the more medical documentation you have, the stronger your case. Documentation of the following is particularly helpful:
- You regularly see a medical specialist for your condition.
- Your condition has resulted in a hospitalization, especially a recent one.
- You have required consistent medical treatment for your condition over time.
The SSA will consider all documentation you provide, so don’t hesitate to add everything you have to your application. You want to build the most compelling case possible, and the more information you have, the more compelling your case will be.
You Don’t Have an Advanced Degree
Having an advanced degree is hardly disqualifying for SSDI. However, not having an advanced degree may strengthen your case for benefits.
If you don’t have an advanced degree, it may be easier to show that you cannot return to work. This is because many jobs that don’t require an advanced degree are more physically demanding and may require skills like manual labor, physical strength, or endurance for tasks like standing unassisted for hours.
You Are Aged 50 or Older
In the SSA’s eyes, the older you are, the less likely you can return to work or receive retraining for a new skill. This means that you are less likely to be able to reenter the workforce and more likely to require disability benefits for an extended period. Therefore, being older may lead to a stronger SSDI application.
For applicants under 50, the SSA considers their education level and past work experience to determine their capacity to do any kind of work. However, those 50 and older only need to prove they cannot do the kind of work they have previously done.
You Have a Terminal Illness
If you have a terminal illness, such as cancer or ALS, you may qualify for a Compassionate Allowance. Compassionate Allowances are an expedited form of Social Security benefit given to people with extremely serious or terminal conditions. These conditions have been predetermined to meet the SSA’s standards for disability, meaning that a person diagnosed with a listed condition is presumed to be severely disabled and unable to work. The program exists to ensure that people who are nearing the end of their lives receive benefits quickly so that they and their families or caregivers are not financially struggling while coping with a fatal illness.
Assembling a Strong Case for Your Hearing
Most people who apply for SSDI are denied benefits on their first application. Therefore, it is highly likely that you will need to appear at a hearing before an administrative law judge, or ALJ.
ALJs can be fickle when deciding SSDI claims. They commonly see dozens of cases a day, so it can be difficult to convince them of the seriousness of your condition. It’s important to put your best foot forward in the courtroom to maximize your chances of a successful appeal.
Strong Testimony
It’s important to be confident when you walk into a hearing. If you have an attorney, they’ll walk you through your first round of testimony and train you not to shy away from cross-examination. Present your case as calmly and thoroughly as you can. Tell the ALJ sincerely why they should reverse your denial.
Medical and Vocational Expert Testimony
Having medical and vocational experts testify at your appeals hearing can seriously strengthen your case. Providing expert insight on why your disability prevents you from working makes your claim much more compelling to ALJ. The ALJ may summon such experts to testify, so it is often in your best interest to counter with your own experts.
Legal Representation
A lawyer with experience navigating the SSDI claims process can help your case immensely. Representing yourself at an SSDI hearing, also known as appearing pro se, is rarely in your best interest. While the judge will understand that you’re doing your best, without an attorney, you’ll likely miss strengths and weaknesses that can make or break your appeal. In addition, an attorney can more effectively cross-examine any experts testifying on the SSA’s behalf.
How To Check the Status of Your Claim
You can check the status of your SSDI claim online or by phone at 800-772-1213. It generally takes six to eight months to hear back on an initial determination. An appeal is a longer process, and you may not hear about your claim for a while.
A knowledgeable disability attorney can help you assemble the strongest possible case for an initial application or appeal. If you need help applying for SSDI or appealing a denial, contact us at Disability Advice today.
- Free case evaluation
- Assist with denied claims
- Ensure you have all documents
- Make the process easy for you
