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Can You Win Social Security Disability Without an Administrative Hearing?

For many Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) claimants the thought of appearing before an Administrative Law Judge and arguing their Social Security Disability case sounds terrifying. Many claimants ask, “Can I win SSD benefits without attending a Social Security Disability hearing?”

While winning SSDI or SSI benefits at the application level is ideal, it can be very difficult. There are two basic ways to win SSDI and SSI benefits: you can prove your disability meets a condition on the Social Security Administration’s Listing of Impairment (a list of mental or physical health conditions which automatically are considered disabling), or you can prove that your mental or physical health condition is so severe that it does not allow you to perform substantial gainful activity. This is called winning benefits through a medical vocational allowance.

Winning Social Security Disability benefits by Meeting a Listing

Unfortunately, many claimants apply for either SSI or SSDI and have very little understanding of what they are trying to prove. One of the best places to start is by reviewing the Social Security Administration’s disability “handbook” which outlines conditions, disabilities and diseases they believe are disabling. This handbook is called the “Disability Evaluation under Social Security,” but it is more commonly referred to as the Social Security Administration’s “Blue Book.”

What is in the Blue Book? This handbook lists all of the major body systems and the symptoms the SSA expects a claimant to display to be considered automatically disabling. If you have one of the listed diseases or conditions, the SSA makes the assumption that your health has so severely deteriorated that you are unable to work for at least 12 continuous months.

What if your condition only partially meets the listing? Unfortunately, this will not be sufficient to automatically win SSI or SSDI benefits.

There are several criticisms of the SSA Blue Book: the handbook can be difficult to understand and some critics argue the common diseases and disabilities are not included.

So to clarify, you may be approved at the initial application level if your condition specifically “meets a listing” and you are not currently performing substantial gainful activity (this assumes that you meet the nonmedical criteria of either the SSI or the SSDI benefit programs).

What if your condition is not as severe as a condition on the list, your condition is not listed or you suffer from multiple conditions and your conditions in their entirety leave you no ability to perform substantial gainful activity (SGA)?

Fortunately, the Social Security Administration has another method called medical vocational allowance that allows them to analyze your residual functional capacity and determine if you have the residual ability to work.

Proving Disability with a Medical Vocational Allowance

If your condition does not meet a listing you will have to win benefits through a medical vocational allowance. Unfortunately, this can be a bit more complicated and many claimants will not be able to do this at the application level.

How do you prove that you are unable to work? You must have sufficient medical documentation to prove that you cannot work your current job, any job you have had in the past 15 years or you cannot be retrained for new work (given your age, work history, transferable job skills, residual capacity to work or education).

The SSA will request information about your past work, including a list of your job responsibilities, and they will use this information in conjunction with your medical information to determine what other work you can perform.

Many claimants wonder if they need the support of their doctor to win benefits. No, you do not, although if your doctor specifically lists in your medical records that you are not disabled or your condition is not expected to last for 12 continuous months this can hurt your disability claim.

If your doctor does support your claim and you are trying to prove you are disabled through a medical vocational allowance, many claimants will ask their doctors to complete a RFC or Residual Functional Capacity form.

The RFC form is given to your treating physician and lists the physical and mental activities you can and cannot do as a result of your physical or mental disabilities. The RFC form can be a critical piece of evidence to prove that you are unable to work certain jobs that the Social Security Administrative may claim that you are able to work.

Why is the RFC form so important? It can provide more objective documentation about your condition and can help to eliminate the subjective analysis (which is often done by the Disability Determination examiner) which can lead to a Social Security Disability denial.

Hiring a Social Security Disability Lawyer

If you would like a Social Security Disability attorney to review your Supplemental Security Income or Social Security Disability Insurance claim you can fill out the FREE evaluation form and a disability advocate will call you to review your claim or you can call our office at 1-800-641-3759 to talk to someone now.