If you suffer from an extremely rare disabling condition that’s recently forced you out of work, then you might be wondering whether or not disability benefit providers have any rules on the books for them. Fortunately, the answer is that, for the most part, they do.
Even if they don’t, certain insurance providers (as well as the Social Security Administration) may still consider you eligible for benefits, so long as the condition’s symptoms are similar to a more medically familiar impairment.
If you still feel that you’re unfairly being denied benefits though, whether through an insurance provider or the SSA, then you’re not without legal recourse to challenge those denials. Find out what those avenues are and find out whether or not you qualify for disability benefits in the first place.
Disability Blue Book Rules
If you’re attempting to claim SSDI benefits through the Social Security Administration, then you’ll want to review their “Blue Book,” which outlines in detail what the SSA constitutes as “impairments” that would qualify for disability benefits. It’s extremely comprehensive, so take your time to read the fine print over carefully. Even if you get into those details, it is not easy to figure whether you fit into those listings. Typically it is extremely difficult to “meet” one of the listings and it is even more difficult to “equal” a listing. These are terms of art peculiar to Social Security disability law.
Even if a listing for your condition isn’t present, you may still be able to qualify for disability benefits if your mental or physical residual functional capacity prevents you from working. This is also complicated and the following factors are taken into account on a case-by-case basis:
- Work experience
- Medical problems
- Transferable skills
For the SSA to approve a claim through a medical-vocational allowance or compassionate allowance for severe rare, severely disabling conditions, they would first need to determine that your condition is severe enough to prevent you from working any job, which is almost always the case with severe terminal illnesses.
Once you’ve determined that your condition qualifies under SSA Blue Book rules, you can then begin to apply for your SSDI benefits. You can start the SSDI application process online at http://www.ssa.gov/, calling 1-800-772-1213, or by visiting your nearest SSA office in person.
However, if you feel your claim was unfairly rejected, delayed, or denied, you do have legal rights to challenge that decision with an appeal of your own. Find out what you can do to secure the benefits you deserve and challenge any unfair rulings.
SSA Disability Appeal
To appeal an unfair disability claim decision, you’re going to have to start your case within 60 days after that initial ruling. Hold on to documentation that substantiates your disabling condition, and work with a trusted disability advocacy attorney to build that documentation into a robust, winning case.
Although you can’t sue the SSA, you do have a legal right to appeal any decisions you think are unfair. You can do so by filing a written complaint, serving an issued summons to your local federal court, filing briefs, conducting oral arguments, and waiting for your judge to make a final ruling.
The case process varies by district, but it may take up to a year for your presiding judge to make that final decision. However, you’ll only have 60 days to start your case, so don’t hesitate to seek help from a disability attorney.