If you are unable to work because of a physical or mental illness, you may be eligible for social security disability benefits. Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) programs provide financial benefits that can help you take care of yourself while you are unable to work. In order to be eligible for benefits, Social Security requires that you be unable to perform substantial gainful activity due to a physical or mental impairment that is expected to last for a least twelve months or result in death. 

Why was my claim denied when clearly I can’t work? This decision makes no sense.

It is a harsh reality for many claimants, but you cannot always rely on common sense to determine who is and who is not disabled under Social Security laws, rules and regulations. This is so because Social Security’s strict definition of “disabled” calls for a hypothetical determination of your ability to work.

The Social Security Administration (SSA) only wants to know whether you are able to work; it does not care or even consider whether, in the real world, you can find suitable work. That said, if you are not able to work because of your physical or mental condition, then it may be that your claim was denied in error. The SSA is a large government bureaucracy and, like all large bureaucratic entities, it makes mistakes.

This is especially true in the early stages of the disability application and appeals process, when the decision-makers tend to rigidly apply the Social Security rules and regulations, with little consideration for the nuances of each individual case. About two-thirds of initial claims for Social Security disability benefits are denied, and many of these are denied erroneously.

Depending on the facts of your case, the possibilities for error are endless. For example, your claim may be erroneously denied if the SSA decision-maker:

• Determines (incorrectly) that your impairment is not severe.
• Fails to consider all of your impairments.
• Fails to consider the impact of all your symptoms.
• Overestimates your ability to function in a work setting; or
• Overestimates your education level.

How does the Social Security Administration determine who gets disability benefits?

The Social Security Administration (SSA) uses a 5-step analysis to evaluate every claim for disability benefits. This analysis requires the Social Security decision-maker to consider the following questions, in the following order. If the answers in your case match our answers below [Yes/No], then you will be awarded benefits. A “wrong” answer at any point will end the analysis and result in the denial of your claim.

• Step 1: Are you gainfully employed? [No.]
• Step 2: Do you have a severe physical or mental impairment that has been diagnosed and documented by a medical professional and is expected to last for at least a year or to result in your death? [Yes.]
• Step 3: Is your impairment found in the Social Security Listing of Impairments? The Listing of Impairments establishes criteria for more than 100 physical and mental conditions that the SSA deems severe enough to be disabling as a matter of law. If your condition “meets or medically equals” the criteria for a Listing impairment, then you are “disabled”. If not, then you must clear both Step 4 and Step 5 to be awarded benefits.
• Step 4: Are you able to do the easiest job you have done in the past? [No.]
• Step 5: Are you able to adapt to new work? [No.]