What happens if I apply for disability for a number of impairments but none of them are listed as automatic qualifiers?
Author Attorney Greg Reed:
Many people who apply for disability benefits suffer from more than one illness or injury which combined leaves them unable to work.
The Social Security Administration defines disability as “the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”
It considers an individual disabled “if, due to an established medical condition, he or she meets or equals one of our medical Listings (criteria that are presumed to preclude work for most people); cannot perform any of his/her work that was done before, or cannot make an adjustment to other work.”
What happens if a person’s separate medical conditions do not meet the criteria of any listings in Social Security’s Bluebook, yet that person is still unable to work because of the effects of several medical issues?
Even though one illness on its own does not qualify a person as disabled, the combined effects of multiple medical conditions may.
The Social Security Administration handles claims with multiple impairments in a series of steps:
- The SSA will decide if an applicant has a severe impairment or a severe combination of impairments;
- If an applicant has a severe combination of impairments, SSA compares the applicant’s impairments to those listed in the Social Security Blue Book; and
- The SSA evaluates an applicant’s limitations during the residual functioning capacity assessment to determine if they are capable of any type of work.
If you have been denied disability benefits don’t give up! Contact a Disability lawyer at 512-454-4000 for a free consultation and get the benefits you deserve.
During the determination process, Social Security must consider if an applicant’s symptoms are “medically equivalent” to the criteria of a specific impairment.
The SSA is not permitted to evaluate a person’s medical conditions separately to see if they meet the requirements of a listing; the SSA must consider the combined effects of an applicant’s medical conditions together. Also, Social Security must consider an applicant’s mental and physical impairments. Depression and anxiety can decrease a person’s tolerance for pain and a physical illness may impair a person’s ability to concentrate or finish a project. A few listings require a person to have a mental or physical impairment in addition to low IQ. For example, Listing 12.05C Intellectual Disability, a person must have an IQ between 60 and 70 and another mental or physical condition that would limit their ability to work.
In addition to comparing a person’s impairments to the Blue Book listings, the SSA assesses an applicant’s physical and mental limitations to evaluate the jobs they can perform despite those limitations.
This assessment evaluates both exertional or strength-related limitations and non-exertional limitations. Exertional limitations are categorized as sedentary, light, or medium work while non-exertional includes abilities such as using the fingers and hands to manipulate or hold objects, seeing, speaking or hearing, and paying attention and understanding instructions. An applicant may be able to perform some level of physical work, but not have the ability to understand or remember instructions. The SSA must consider all of a person’s impairments to determine residual functioning capacity, even if an impairment is not listed in the Blue Book.
In contrast, LTD companies will separate a claimant’s impairments when reviewing a claim in order to dilute the severity of a person’s disability.
This is a common tactic among LTD companies to deny claims. An LTD company may ignore or dismiss a medical condition. It may send out only portions of an applicant’s medical records to medical specialists so the expert does not see a complete picture of a claimant’s condition. Since one impairment may not qualify a claimant as disabled, it is vitally important to connect all the impairments for a claim to be approved.
Despite strong medical evidence proving a person is disabled, Social Security or an LTD company may argue that they can still perform some jobs and deny benefits.
A qualified disability attorney can help appeal the denial and obtain the benefits a person with disabilities deserves.
Multiple Impairments – A Case Study
Austin Social Security lawyer Greg Reed, of Bemis, Roach & Reed, was retained in June by a Dripping Springs client to help her with a disability claim.
Our client’s journey began like many others we see: she enjoyed keeping a clean, organized home and working at her “dream job” as a headquarters’ program/analyst where she was earning a sizeable salary.
She cooked every day from scratch, read, watched television, and loved spending time with her family. Also like many of our other clients, her deteriorating health caused increasing difficulties both at home and at work. Our client was left with no choice and eventually made the decision to file for Social Security Disability Insurance.
This particular client assumed it would be simple. She knew she was disabled. Her doctors knew she was disabled. Certainly Social Security would agree. No such luck.
She initially filed a claim for disability benefits on her own.
When she was denied, she hired Bemis, Roach & Reed to represent her in an appeal of a ruling made by the Office of Disability Adjudication and Review, a division of the Social Security Administration.
Our client experienced a number of challenges.
Our claim for benefits included documented complaints of degenerative joint disease of the left knee, degenerative disc disease of the spine, coronary artery disease,obstructive pulmonary disease, obstructive sleep apnea, diabetes mellitus, type 2, major depressive disorder, panic disorder, fibromyalgia, GERD, diverticulosis, IBS, hypertension, elevated cholesterol, migraines, vertigo, and neuropathy—although more documented claims were made when we appealed and filed for benefits. On August 29 a video-conference hearing proceeded Mr. Reed and his client appearing in Austin and the Administrative Law Judge and the Social Security Administration’s witnesses (a medical doctor, a mental health professional and a vocational expert), appearing in San Antonio.
Prior to the hearing, Bemis, Roach & Reed obtained every single pertinent medical record associated with our client’s medical conditions and made sure they would be available for review. We also obtained medical statements from her doctors.
Our client’s records were very persuasive. She fought long and hard for her rights and then placed her future in the hands of this firm to do battle with the Social Security Administration on her behalf.
We are happy to say we prevailed and that justice was served.
On August 30 a “Notice of Decision—Fully Favorable” finding was made by the Administrative Law Judge and was received by Bemis, Roach & Reed on September 7. Our client won the day—sadly, she is no longer able to do those cherished activities she once enjoyed but she was fully and finally vindicated and her day in court resulted in the correct, albeit long overdue, finding.
Food for Thought:
The Social Security Administration brought its own experts to comment on our client’s complaints. The experts were not supportive. Based on the medical evidence and testimony gathered and submitted by Bemis, Roach & Reed, our client was found to be “severely” impaired. A claimant’s impairment is “severe” if it
meets the standard of Stone v. Heckler, 752 .2d 1099 (5th Cir. 1985), which provides: “An impairment can be considered as not severe only if it is a slight abnormality (having) such minimal effect on the individual that it would not be expected to interfere with the individual’s ability to work, irrespective of age, education, or work experience.” We wish the very best for our client and hope that this ruling will give her some measure of peace and relief. Although there is nothing we can do to restore her to her once active and healthy lifestyle, she can rest secure in the knowledge that she was heard, she had her day in Court, and we did our very best to make her as whole as we are able.
Disability benefits are an important source of income for those who are unable to work. If you not able to work due to accident or illness, you may be eligible for Social Security Disability or Long Term Disability benefits. If you have applied for benefits and been denied, contact the attorneys at Bemis, Roach and Reed for a free consultation. Call 512-454-4000 and get help NOW.
Author: Attorney Greg Reed has been practicing law for 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion Gold rated by Martindale Hubbell. Through his extensive litigation Mr. Reed obtained board certification from the Texas Board of Legal Specialization. Greg is admitted to practice in the United States District Court – all Texas Districts and the United States Court of Appeals-Fifth Circuit. Mr. Reed is a member of the Travis County Bar Association, Texas Trial Lawyers Association, past Director of the Capital Area Trial Lawyers Association, and an Associate member of the American Board of Trial Advocates. Mr. Reed and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.
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