Three Winning Arguments in Disability Cases
As a large federal bureaucracy, the Social Security Administration has a dizzying array of procedures and forms that it uses to process disability cases. Social Security procedure manuals require disability adjudicators and judges to use something called a "sequential evaluation process" to evaluate every disability case. In case you are interested, the five steps of the process are as follows:
- Are You Working?
- Is Your Condition “Severe”
- Does Your Condition Meet a Listing?
- Can You Perform Your Past Relevant Work?
- Can You Perform Any Work
Hundreds of words have been written about each step of this process and the Appeals Council and District Courts produce voluminous written opinions that explain what each of these words mean and how they should be applied.
As a busy attorney dealing with disability cases on a day to day basis, I don't have the time or patience to deal with the minutia of Social Security jurisprudence. Instead, I worry about what it takes to win.
With apologies to the drafters of Social Security's POMS – Programs Operation Manual System, it has been my experience that there are 3 ways to win a case:
- Meet a listing
- Prove that your functional capacity for work (i.e. Residual Functional Capacity) is less than sedentary
- Meet a grid rule
You can read more about how I apply these three "theories of disability" in a back case by clicking on the link.
In my experience about 15 of cases that end up at hearings are decided under a listing theory and about 15% are grid rule cases. That leaves approximately 70% of the cases that I try as RFC cases. Note that my percentages may be similar or different that what you might experience where you live.
In my view, Social Security disability practice fits fairly neatly into this three theory box. I use this approach in every case in my office and I am always able to fit the facts of any particular case into one, two or all three of these arguments.
If you are a lawyer and you want to learn more about how I set up and manage my practice, I am teaching a course entitled "Creating a Social Security Disability Practice at Solo Practice University, an on-line learning resource.
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Comments on Three Winning Arguments in Disability Cases
I have hypersomnia/narcolepsy and I am awake and functioning approx. 3 hrs a day before I need a nap. My hearing is 1 month from now and could use and tips you may have thanks.
Kim, if you have a "symptom diary" detailing your episodes of napping throughout the day, that could be helpful evidence. More importantly you need documentation from a treating doctor confirming the frequency and duration of your uncontrollable sleeping.
With vision problems that include past scleral buckle surgery, diagnosis with frequent ophthalmic migraines (short periods of blindness), migraines with aura, and a new evaluation of cataracts at age 53 I'm not sure if I'm up for the rigors of a social security claim. I'll do it, but I'm still afraid to apply as my energy reserves are at an all time low. Do you have any insight on what is required with vision problems like mine? I'm willing to work, but don't think I can do this without cataract surgery and rehabilitative services.
I had my hearing on Dec 16 2010, for SSI benifits. At the hearing there was a vocational expert. It's now April and I still haven't gotten a judgement. My question is, why would a judge ask for a 2nd opnion from another vocational expert?
Kim, I also have severe Narcolepsy with Cataplexy plus Fibromyalgia and RA, so I totally relate. I had my hearing a week ago, and I think it went well, but we shall see. My life is but a shell of what I wanted it to be. What a difference severe disability has on one's life!
hi i have finally had my hearing after about 4 yrs as i went in hearing room with my attorney there was judge court reporter and vocational expert the judge sworn me in ask my name date of birth and correct mailing address and phone number then he ask the vocational expert regarding what types of work i can do the vocational expert answered no to all judges questions saying i could not do any type of work period and that was it he the judge didnt ask me any thing else and the judge ask my attorney did he have any thing to say and my attorney said no i wasnt in the hearing room no longer than 5 minutes does this means the judge approve me
I have diabetes 5 shots a day sciatica diabetic periphial neuropathy major depression fibro hypertension osteoarthritis and ptsd I'm waiting for a hearing will I be approved and I have to mention the side effects of taking 9 meds a day