WHO IS LIKELY TO WIN A DISABILITY CASE?

As you have observed, Social Security disability benefits are getting harder to get. Attorneys or advocates can only afford to work with clients who have a fair chance of winning.

So, what would the ideal disability candidate look like?

1. A Long, Steady Work Record. Social Security wants to see a strong work ethic, i.e., someone who has consistently worked over the years without too many gaps in employment.

2. Age 50 or above. While younger individuals can and do get approved for SSDI, being 50 or over has definite advantages. At 50 a claimant may use a "grid rule" or Medical-Vocational Guideline to win without going through all 5 steps of the sequential process.

3. Regular, Current and Consistent Medical Treatment. Social Security wants to see that you have gone to the doctor and done everything possible to improve. They want compliance with medical advice. It's also important to have objective medical evidence to support your symptoms. In other words, for physical problems, you need X-rays, MRI, CT, lab work, EKG, etc.

4. A Severe Impairment Lasting at Least 12 Consecutive Months OR expected to end in death. Any impairment not lasting at least 12 months won't be paid by SSDI. It's called the "Duration Requirement." The exception would be a terminal illness that is expected to result in death. If a condition is expected to get better within a year, it won't meet the duration requirement.

5. A Definite Diagnosis. While a diagnosis alone isn't enough to win benefits, Judges want to see that a medical determination has been made for the cause of the problems. For example, if the problem is severe back pain, they will want an X-Ray or MRI showing something like a herniated disc, neural foraminal stenosis or nerve root impingement. It won't be sufficient to have unexplained back pain in the medical record.

Very few disability cases are perfect. Most cases have both strengths and weaknesses. An advocate's job is to emphasize the strengths and mitigate the weak points. When we evaluate a case here at my office, the 5 items above are what we look at.

I once hear a colleague state that the most important factor in a disability case is the medical record. I totally agree. He also said, when you look at what really matters in a case......

• It's 85 percent medical records

• It's 10 percent what the claimant says to the judge, and

• 5 percent what the lawyer or advocate does

While I'd like to take a little more credit for victorious cases, I can't disagree with my friend.