The Social Security Administration offers disability benefits for a wide variety of conditions. However, some conditions are more difficult to prove than others. It’s good to know which conditions fall under that category before you apply for disability benefits.
There are a few conditions that are harder to prove than others.
Four disabilities that are hardest to prove include chronic migraines, fibromyalgia, mental disorders, or back injuries. To get disability approval for these conditions, you must make sure to provide extensive medical proof.
Read below as we talk more about these conditions and what kind of evidence they require.
SSDI Overview
Social Security Disability Insurance (SSDI) is a federally funded program that is managed by the Social Security Administration. It provides financial support to people who are unable to work because of a medical condition that has been diagnosed as either long-term or terminal.
People with a partial disability or a temporary disability are not eligible for SSDI benefits.
The applicant must satisfy the Social Security Administration’s disability criteria to receive SSDI benefits. The Social Security Administration considers a person disabled if they have a condition that prevents them from engaging in substantial gainful activity for at least 12 months.
4 Disabilities That Are Hardest to Prove
There are many conditions that don’t precisely match the Blue Book listings, even though they are debilitating enough to keep you from employment. Conditions that are more difficult to prove include the following:
Injury to the Back or Neck
Injuries to the neck, back, or spinal cord are a common cause of disability. The Social Security Administration does not approve disability claims for impairments that are not severe or lasting.
You can demonstrate that your injury has kept you from working for more than a year by providing evidence such as MRIs, CT scans, test findings, and testimony from your healthcare practitioner.
Chronic migraines
Claiming disability due to chronic migraines is challenging. Even though the Social Security Administration recognizes a wide variety of medical disorders, migraines are not one of them.
If you’re applying for disability benefits based on your chronic migraines alone, you’ll need to provide extensive documentation, such as reports from your doctors and a list of the treatments and medications that you’ve tried.
Fibromyalgia
There are some conditions that, even when listed in the Blue Book, can be hard to prove. Consider, for example, the condition known as fibromyalgia.
Although the Social Security Administration recognizes fibromyalgia as a valid medical diagnosis, it can be difficult to prove. The basic symptoms of fibromyalgia—chronic pain and exhaustion—are also associated with a wide variety of other illnesses and medical disorders, leading to frequent misdiagnosis.
An extensive medical history and treatment by a rheumatologist can both help your case for fibromyalgia disability benefits.
Mental Disorders
It is difficult for the Social Security Administration to determine the severity of mental health conditions because these symptoms usually vary from one individual to another. It is also more difficult to create uniform standards for what constitutes a significant impairment when dealing with mental disease than it is when dealing with back pain or a blood disorder.
In addition, the majority of mental health issues are not quantifiable by tests or other conventional medical procedures, in contrast to physical symptoms. These are the principles upon which Social Security Administration specialists have been trained to evaluate patients.
It is also quite unfortunate that disability examiners and judges are sometimes biased and skeptical when it comes to mental health claims. This is because they do not always consider mental illnesses to be as legitimate as physical conditions.
This form of disability claim can be strengthened by providing evidence of consistent medical treatment that has been meticulously documented, as well as a history of working with mental health practitioners to treat the condition.
When applying for disability payments, claimants who present a combination of a mental disorder and a physical condition frequently have a better chance of being approved than those who present solely with a mental disorder.
What is Considered Substantial Medical Evidence?
The Social Security Administration maintains a list of diagnoses that warrant disability payments. The likelihood of having your claim approved decreases if your illness or injury does not fulfill these criteria.
To increase the likelihood of having your claim approved, you must submit the following medical evidence along with your application:
- Diagnostics reports
- Purchase receipts for prescribed drugs
- Treatment-related medical records
- Reports from imaging exams
- Doctors’ notes detailing the condition, symptoms, and treatment
Your diagnosis must be included in your records as well. The Social Security Administration is more likely to deny your claim for a broken leg, for example, if your application has no supporting evidence of your injury.
You’ll also need to provide evidence that your health problem makes it difficult for you to perform the fundamental responsibilities of your work. If you are unable to demonstrate that you can’t carry out the responsibilities associated with your job, your application will not be approved.
The Social Security Administration requires evidence that a disability has lasted for more than twelve months in a row. Your injury or illness must be severe enough to prevent you from returning to work in your current line of work or any other type of work.
If you don’t have proof that you’ll be out of work for a year due to an injury or illness, the Social Security Administration will likely deny your claim. Medical records showing how your condition affects your ability to do daily tasks will be required.
If your impairments have a major effect on your ability to perform even the most fundamental aspects of your employment, you can provide the Social Security Administration with a copy of your job description.
How to Get Disability Approval With A Hard-to-Prove Disability
You can increase your chances of being approved for disability payments despite having a difficult-to-prove disability by doing any of the following:
- by accumulating additional medical proof that your symptoms fit the description in the updated applicable blue book listing;
- by obtaining a medical opinion from your doctor stating that, due to your impairment, you would be unable to work for a minimum of 12 consecutive months;
- by having a medical professional conduct a residual functional capacity (RFC) test to determine your current level of physical and mental functioning;
- by keeping up with treatment and collecting documents from doctors detailing your condition’s changes.
The RFC examination may make it more evident that you are unable to continue working due to your debilitating condition, making it possible to be approved even though your medical condition may not be stated in a Blue Book listing.
If you have a mental impairment, you could also have a mental residual functional capacity (MRFC) test to demonstrate how your condition impacts your ability to continue working.
How to Tell if Your Disability Claim is Weak
There are some telltale signs that can help you determine whether your disability claim is weak and needs improvement.
1. Insufficient Medical Evidence
Lack of sufficient medical proof is a major factor in the denial of Social Security Disability applications. To get disability payments, you must demonstrate that you are medically and physically unable to work because of your disability.
The Social Security Administration defines a severe disability as a condition that interferes with a person’s capacity to carry out basic work-related activities.
You need to have medical records that demonstrate how your disability has hindered your ability to carry out basic work related activities to get approval.
Many people believe that if they file for Social Security Disability benefits, the agency will arrange for them to see doctors who will provide the necessary documentation.
This is not at all true. Even if the Social Security Administration orders you to undergo a medical evaluation, this still isn’t sufficient evidence to prove that you are disabled.
If you’re applying for Social Security disability benefits, your primary care doctor’s records will be the most crucial piece of evidence. Therefore, you must tell your doctor how your disability is influencing your ability to work.
If at all possible, you ought to submit doctor’s notes that excuse you from work or records that indicate time off work along with your medical records. Keep track of the number of days you missed work because of your condition if you were working before you filed for disability.
2. Earnings
Sometimes a person applies for SSDI benefits while still working part-time. Your application for Social Security Disability benefits may be denied, however, if you are working and earning more than $1,470 per month at the time you submit your application for these benefits.
Claimants for Social Security disability benefits must demonstrate to the Social Security Administration that they are unable to maintain gainful employment owing to their disability to have their applications approved.
3. Noncompliance with Medical Recommendations
The Social Security Administration will deny your claim if you do not comply with your doctor’s recommended course of treatment.
The reasoning behind this denial is that if you do not comply with the recommended treatment guidelines, then the Social Security examiner will be unable to assess whether your condition keeps you from retaining employment.
If there is a good reason why you did not carry out the treatment plan that your doctor recommended for you, you have the option of bringing this up throughout the appeals process. In any case, it’s best to consult with a disability lawyer in such a situation so they can give you the appropriate guidance.
4. Non-Cooperation with Social Security
During the process of applying for Social Security disability benefits, it is in your best interest to cooperate with the individuals who will be managing your claim.
Your claim will be denied if you either do not supply the Social Security office with the appropriate documentation or do not appear for your scheduled medical exams. Therefore, keep in touch with the caseworker and promptly submit any needed paperwork.
Medical Vocational Allowance as an Alternative
You may be qualified for benefits via a Medical Vocational Allowance even if you are not eligible for benefits according to the listings in the Blue Book. However, to be eligible for the Medical Vocational Allowance, you will need to undergo a Residual Functional Capacity test done by your doctor.
To determine whether or not you can work, the Social Security Administration will review the evaluation form you submitted in addition to your employment history and capabilities. If the Social Security Administration is unable to identify employment you could perform , then you may qualify for benefits.
Making Ends Meet During Your Social Security Application
While waiting for a decision on your Social Security disability application, you may want to explore other sources of aid if you qualify. Disabled workers who are temporarily unable to find employment may be eligible for temporary disability compensation in several states.
Alternatively, if you have private disability insurance, you may be eligible for short-term disability benefits before being authorized for SSDI and/or Supplemental Security Income.
If you want your Social Security disability claim approved as quickly as possible, you should hire an experienced lawyer to help you fill out the necessary paperwork and submit it to the Social Security Administration.
Conclusion
In conclusion, there are a few conditions that may make it more difficult for you to get disability approval. It is important that you provide the required documentation and medical evidence to strengthen your application.
