In order to qualify for disability benefits under Social Security you have to be found disabled.
Well, thank you ‘Captain Obvious’
Ok. But, what does it mean to be disabled?
Are symptoms enough?
How about limitations?
Is a diagnosis, itself, enough?
In short, no. Under Social Security regulations, it is none of these are enough qualify for Social Security disability.
- Without a diagnosis (what SSA calls a “medically determinable impairment”), symptoms alone cannot be the basis of a disability claim. This means that if your doctors cannot put a “label” on your condition, you might not be able to win your Social Security case.
- Once you have a diagnosis, you still don’t have a slam dunk disability case because there are very few conditions where the diagnosis is enough to win disability benefits. The diagnosis isn’t enough because a condition may cause a lot of limitations or very little. It may be well control with medications, or no amount of treatment will help. So, what Social Security needs is a statement of how your diagnosed condition affects your ability to work (aka your limitations).
- Limitations are a critical part of a disability case. And you would think from reading the first two bullet points that if you have a diagnosis and limitations then, FINALLY, you would be done with your disability case. However, that may not be the case. I have met with hundreds of people with limitations from car accidents and workers’ compensation cases with clear cut, medically documents limitations. The problem is that the limitations still allow for some kind of work.
The Touchstone of Social Security disability
And now we have come to critical part of this: while you absolutely have to have a diagnosed condition and limitations (those get your foot in the door at Social Security), the limitations have to be severe enough to prevent you from being able to engage in a “Substantial Gainful Activity (SGA)” which translates to full-time, competitive, employment.
Put another way, the touchstone of a Social Security disability case is the question, “do your conditions keep you from being able to do some type of full-time work.”
That is what Social Security means by “disabled.” And, that is what you have to prove what you are applying for Social Security disability.