When determining what qualifies an applicant for Social Security disability, the primary emphasis is on the nature of the physical or mental impairments specified. While this focus should come as no surprise, many California applicants are dismayed and disappointed to learn their particular impairments do not meet the Social Security Administration’s listing of impairments, and they are denied benefits. Even harder to believe are the circumstances where an individual applies for benefits, has an impairment listed by the SSA specifically but is nonetheless issued a denial letter.
To be clear, it is possible to be approved for benefits without having a listed impairment. A finding that the applicant’s level of impairment is equivalent to a listed impairment could be a pathway to approval, although such a conclusion is more likely to occur at an administrative law hearing. Such a hearing may take place only as a second level of appeal following the initial application and reconsideration. However, Social Security experts indicate there may be some reasons why an applicant who suffers from a listed impairment may be denied benefits.
In addition to the medical determination of disability, the SSA also has non-medical criteria that each applicant must meet. If the individual is applying for SSI, a needs-based program, qualification is predicated on having limited income and assets. Under SSD guidelines, which is more like an insurance program each worker pays into, specific work credits must be accumulated to be eligible, and any income earned while claiming disability must be limited to under what is considered the substantial gainful activity level.
The Social Security Disability system is a complex maze of regulations and opinions based on previous cases. It is each applicant’s legal right to be represented by a Social Security Disability lawyer at any stage of the proceeding if they so choose
