HOW CAN YOU BE DISABLED BUT NOT ELIGIBLE FOR A BENEFIT?

Unfortunately, it is quite possible for an individual to be disabled and still not entitled to a disability benefit under the law.  How is this possible?

One way is to wait too long to file a claim.  Disability coverage expires.  You only have a certain number of years to file a claim after you stop working.  Wait too long and it doesn't matter if you are disabled, your coverage has lapsed and you can't get a benefit.

Another way is to work at substantial gainful activity while trying to get a disability claim approved.  People tell me all the time, "I am really disabled but I'm forced to work to keep my home..."  In the eyes of the government, if you are working you are not legally disabled. 

In another really unfortunate scenario, an individual may have disabling conditions but lack the medical evidence to prove it.  Persons with no medical insurance, no job and limited financial resources may have trouble going to the doctor for treatment.  Thus, they lack the evidence to convince the government that they are legally disabled.  The only solution to this problem is to find a way to see a doctor and get the evidence.

A related problem is claimants who do have medical evidence, but not from an "acceptable medical source."  Social Security wants evidence from a medical doctor.  They may not accept evidence from a counselor, chiropractor, therapist or nurse practitioner.

Most claimants are quite surprised to see how skeptical judges are when they appear before them.  Nearly all judges will take the stance that if it isn't in the medical record, it can't be counted as credible.  This is because federal law requires consistent objective medical evidence of a disabling impairment. In other words, Social Security wants X-rays, MRI imaging,laboratory tests, or other studies to explain your symptoms and problems.

For example, a claimant may testify that he can stand no more than 20 minutes, sit no more than one hour and walk no further than 200 feet without resting.  The judge will want to know (1) Where is the medical evidence showing an impairment that would result in these kind of restrictions?-- or (2) Is there a medical source statement where your doctor places these restrictions on you?

Someone has said, "The path for Social Security disability benefits runs through your doctor's office."  This is a true statement.

A good attorney or representative will act as liaison between your doctor and Social Security, helping to insure that the medical evidence is there before the day of the hearing--and helping the judge to find the evidence needed to approve your claim.