Unlike Social Security retirement benefits, Social Security disability is not automatic. When you apply for disability benefits, you – the claimant – must prove that you meet SSA’s definition of disability.
Social Security defines disability as the inability to engage in substantial gainful activity because of a medically determinable condition or conditions that has lasted 12 consecutive months (or is likely to last 12 consecutive months) or result in death.
How do You Prove that You are Disabled?
There are three approaches you can take to prove that you meet Social Security’s definition of disability. Not every approach or theory of disability” applies in every case, but you can present more than one theory if applicable. The three theories include:
- Meet a Social Security Listing (focus of this web site)
- Fit within the medical-vocational guidelines (the grid rules)
- Prove that your capacity to perform even a simple, sit-down, entry-level job has been so reduced by your impairments that you would not be a reliable worker 8 hours a day/5 days a week (the functional capacity argument)
What is a Listing of Impairment?
SSA’s listings describe for 14 different body systems, medical problems which are deemed serious enough to prevent you from functioning in a full time work setting. In other words, if your medical/mental health condition meets a listing, SSA assumes that you cannot work and you do not have to introduce any other evidence about your work capacity.
By contrast, if you do not meet a listing, you will have to introduce additional evidence about your diminished work capacity, such as school records, testimony from former co-workers, opinion evidence from your doctors.
In this regard, listing level cases are usually decided faster since the Social Security decision-maker – the adjudicator or the judge – does not have to evaluate anything other than medical evidence. If your case meets a listing, there is a good chance it will be approved at the initial or reconsideration appeal stage, although a few listing level cases end up at hearings.
Why Might a Claimant with Serious Medical Problems Not Meet a Listing?
There are several reasons why your case might not be approved as a listing level case, despite its severity. Click here to read more about these reasons.
How Can You Increase Your Chances at Meeting a Listing?
The goal of this web site is to help you improve your chances at a fast approval based on a listing argument. Click here to read more about the listing argument strategy and here to read some listing level case studies.
Do You Need a Lawyer to Present a Listing Case Argument?
When you first apply for disability, you do so yourself by calling the “800” number of by applying on line. Most disability lawyers do not get involved until you receive your first denial. If you would like some guidance about starting your application, please check out attorney Jonathan Ginsberg’s “how to” book – the Disability Answer Guide for step by step help with the initial application procedure.
If you are denied at the initial application stage, you must file an appeal called a “request for reconsideration” within 60 days from the date of your denial. Many claimants choose to associate a lawyer to help with the recon appeal.
If your case is denied at the reconsideration appeal and you need to request a hearing (again, within 60 days from the date on your reconsideration denial), you will end up appearing before a judge at a hearing. While a lawyer is not required at the hearing level, your chances are significantly better with a lawyer by your side than without.
Note that there is no requirement that you involve a lawyer in presenting your case to Social Security as a listing case. However, an experienced disability lawyer can help gather the evidence that may be needed to prove that you meet a listing and can help frame that argument clearly and concisely.
Summary: not every Social Security disability case will meet a listing because there are not listing categories for every medical issue, and because the exact evidence may not be available. However, if your case can be decided based on the listing, your will get your favorable decision much faster and without the need for a hearing. As a starting point, every SSDI and SSI case should be reviewed as possible listing level case.