Which Disability Cases are Harder to Win?

I've come across a number of discussions online that start out something like "what kind of disability cases win?" or "will it be hard to win disability with my condition?".

As a former disability examiner for social security, I'm tempted to say that there are certain conditions that are harder to win disability benefits for, and there are certain conditions for which the prospect of winning is easier. However, that's so general an answer that it's not really correct.

In actuality, the harder cases to win are simply those for which the medical evidence does not conform to the social security definition of disability. In other words, regardless of your condition (whether its fibromyalgia, lupus, arthritis, degenerative dic disease, bipolar disorder, depression, traumatic brain injury, etc, etc), the medical evidence that's obtained simply needs to prove the following for you to receive social security disability or SSI disability benefits:

A) That your condition is severe enough to prevent you from working (at a former job or in some other form of work) and earning a substantial and gainful income (here's the amount that correlates with this -- substantial gainful activity).

B) That your disability has either lasted a full year or can be expected to last a full year.

That's pretty much it. You win disability if your condition is severe enough to prevent you from working and earning a substantial and gainful income for a year or longer. And it really doesn't matter what your condition is.

A lot of people, of course, make the assumption that certain cases for which certain impairments are chiefly alleged are harder to win. And to some extent, that may be true. However, I've seen cases involving severe third-degree burns to as much as a quarter of the body's surface area...get denied (incredible, isn't it?). And I've seen cases involving adult incontinence get approved (the claimant won because he diligently, and smartly, recorded ALL his episodes of incontinence in a multi-year journal that filled up a lot of diary books).

It just goes to show that the name of the condition is not the most important thing. It is the degree to which the condition is limiting that is important and whether or not the existing medical evidence substantiates limitations that will preclude substantial gainful work activity for at least a year.

In other words, any disability case can be won if you can back it up with the evidence.



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