There is no question that Social Security has made it much more difficult to qualify for disability benefits. Statistically, hearing approval rates have dropped from 62% in 2010 to 45% in 2015, which is a significant drop. There is one hopeful sign: approval rates by judges nationally in 2014 were also 45% which suggests that the trend is not getting worse.
No doubt our elected representatives in Washington, D.C. have been putting pressure on Social Security officials to keep approval rates down. The disability trust fund came close to running out of money in 2016, but at the last minute was shored up when Congress transferred funds into the disability funds from other accounts. There is also a widespread perception that judges have been too lenient in approving claims, and there have been a few high profile cases of outright fraud (although these cases capture a lot of attention they represent only a tiny fraction of awards).
In my practice I definitely sense that administrative law judges give much more scrutiny to claims of younger individuals – Social Security defines “younger individual” as anyone under the age of 50. No doubt, SSA administrators regularly remind judges that a 30 year old approved claimant will be drawing on the trust fund for another 30 years, whereas a 55 year old claimant will likely draw on the fund for only 7 or 8 years.
So, if you are under the age of 50, you will have more of an uphill battle. However, disability judges regularly approve younger claimants if the medical and other evidence directs a finding of disability. Here the most important factors that I consider when evaluating a claim by a younger individual:
Consistent medical care – judges do not want to see gaps in your medical care. Ideally you will need records from a long time treating physician or physicians, as well as records from a specialist (if applicable).
Support from one or more treating doctors – the main issue in your disability claim has to do with the impact your medical condition has on your capacity to work. More specifically you will need to prove to the judge that you would not be reliable and capable of performing the duties of a simple, sit-down type of job. The best evidence you can submit is statements from your doctor identifying work limitations caused by your medical condition. In my practice I use functional capacity forms or narrative reports. If your doctor will cooperate, your chances of winning go way up.
Long and consistent work history – judges respect and appreciate disability claimants who have worked consistently over a long period of time. Judges understand that if you have worked your way up to a position of responsibility with good pay and benefits, you would not suddenly quit your job to sit at home for 2 years waiting for SSA to make a decision.
Work attempts – my experience has been that judges respect claimants who have tried, but failed to return to work. Sincere, but short lived work attempts can enhance your credibility.
Nature of your diagnosis – my experience has been that judges are more comfortable approving claims filed by younger individuals when those claimants are afflicted by medical conditions that can be documented by objective testing like MRIs and CT scans. For example, multiple sclerosis, irritable bowel syndrome, post-surgical unstable spine, traumatic brain injury, Type I diabetes are all conditions that are subject to medical tests, and most likely will be permanent.
By contrast, conditions like fibromyalgia, chronic fatigue, CRPS, depression, anxiety, or ADHD are less apparent using objective medical testing and your degree of impairment is much more subjective. If you are a younger claimant, the judge is less likely to give you the benefit of the doubt.
Other conditions that are objectively determinable, such as bulging or even herniated discs, Type II diabetes, obesity, COPD, osteoarthritis can be difficult to win because these conditions are relatively common and your judge may conclude that you could work through the discomfort or that you could improve your health with lifestyle changes.
Obviously you know better than anyone how you feel about the prospect of trying to work a job 8 hours a day, 5 days a week. But if you are thinking about pursuing Social Security disability benefits, you need to understand that the process can take 2 to 3 years and that if you are 50 or younger, you will need very convincing evidence.
As always, if you would like to talk to me about your case, I am happy to offer my opinion. You can reach me directly at 770-393-4985 or by email at http://bit.ly/contact-Jonathan.