Even though there are rules to follow, the SSA is full of human beings interpreting the rules. We all know that people are subjective. One person at the SSA looking at your claim might feel differently than the next person. One person’s claim might get the seal of approval quickly and without much scrutiny, while yours ends up on the desk of a SSA employee who is very critical. Each judge has a different ratio of approved clams to denied claims. This is why it’s so important to have a lawyer at your hearing. One who is there to make sure the rules are followed, and to present the best evidence possible to satisfy these rules.
Sometimes people are denied simply because they don’t fit in the system. Unfortunately, if you haven’t worked much in your lifetime, and you have a spouse who works, you might be left out in the cold. Think of a homemaker with a working husband. If your neighbor receives benefits but has never worked, they probably receive Supplemental Social Security Income (SSI) benefits. In order to qualify, a person must not only be disabled under the rules, but also must meet specific rules for income and assets. The other type of benefits called Social Security Disability benefits (SSD) are based on a lifetime earnings record and your ability to prove that you became disabled within a specific time frame. Generally this is about 5 years after you stopped working.
The good news is the SSA does have strict guidelines about certain lifestyle choices of claimants. For instance, “A person’s claim will be denied if their substance abuse problem contributes to or causes a disability”. Of course, even this is subject to interpretation within an individual claim. But generally, no one in this day and age is getting benefits because they were injured while under the influence.
Applying for disability benefits can be a very frustrating process, especially when you know of someone who already gets benefits but seems to have few health problems. Even though it might seem like you should get approved right away, you might have to fight for your benefits. Having an attorney on your side to navigate this sometimes crazy system might just make the difference between getting approved and denied.