DISABLED "ACCORDING TO OUR RULES"

Individuals come to my office with Social Security denial letters hundreds of times each year.  There is one sentence, hidden away somewhere in the denial letter, that really gets to the heart of why the claim was denied.

"...You are not disabled according to our rules."

Social Security's definition of disability is very narrow.  Furthermore, their system of proving disability is very strict.  You have to know their rules and follow them to be approved.

Here are a few of the rules that you absolutely must prove in order to get Social Security disability (SSDI) benefits:

• You have not been working at a level of substantial gainful activity since you applied for SSDI benefits.

• You have a medically determinable impairment that is severe and has lasted for at least 12 consecutive months, is expected to last for that long, OR is expected to end in death.

• You must prove your residual functional capacity--that means, what is the most you are able to do in terms of work activities?  Work is measured by its exertion requirements:  sedentary work, light work, medium work, heavy work and very heavy work.  At which level are you able to perform?  Can you do even sedentary work?  (Mental or psychological factors will also enter this picture later on).

• You must prove with medical evidence that you are not able to perform ANY of the jobs you have held within the past 15-year period. 

• If you are under age 50, you must also prove that there are no other jobs in the national economy that you could perform--based on your age, past work experience, education and residual functional capacity.

Unless these five basic facts can be proven (proven, not just alleged)--then Social Security will not pay a benefit.

When Social Security says that a claimant must prove disability according to our rules, they mean it.  There are thousands of pages of complex regulations about what is "proof" and what is not.

Is it possible for a truly disabled claimant who is unable to work to be denied?  Not only possible, it is common.  Being disabled does not qualify for a benefit.  PROVING that you are disabled according to the government's rules....that's what gets a benefit.
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Charles W. Forsythe is a founding partner at the Forsythe Firm in Huntsville, AL.  (256) 799-0297.

FORSYTHE FIRM DISABILITY WEBSITE