Issues Social Security Does Not Usually Consider When Evaluating a Disability Claim

When applying for Social Security Disability Insurance (SSDI), it’s essential to understand what factors the Social Security Administration (SSA) will consider. Certain aspects of your health and daily functioning play a role in determining eligibility, but there are also factors the SSA will not consider. Knowing what is or is not important can help claimants focus their efforts on the information that makes a difference.

1. Your Financial Need or Hardship

A common misconception is that financial hardship alone can justify a claim. The SSA does not base its decisions on how dire your financial situation may be. While lack of income can certainly create personal stress, it doesn’t prove disability. The SSA evaluates whether your medical conditions prevent you from working, regardless of your financial circumstances.

2. Job Availability

The availability of jobs in your area or within your field is irrelevant to your claim. The SSA’s focus is not on the current job market. Rather, the SSA looks at whether you are capable of performing any type of work, regardless of job availability. Even if there are no jobs in your area that match your qualifications, the SSA will not approve your claim if they believe you can work.

3. Employer Willingness to Accommodate

If your employer has made reasonable accommodations for your disability or has been flexible with your work responsibilities, this will not affect the SSA’s decision. The SSA is concerned with your ability to work under ordinary circumstances, not whether a specific employer is willing to make exceptions for you.

4. Your Work History or Career

Although your work history can be relevant in determining whether you can return to a past occupation or adapt to a new type of work, the SSA does not give weight to how long you’ve worked in your field or how successful your career has been. What matters most is whether your medical condition limits your ability to perform any substantial gainful activity (SGA), regardless of the nature of your previous jobs.

5. Disability Insurance or Workers’ Compensation Decisions

Receiving workers’ compensation or private insurance payouts may show that you have a serious condition, but the SSA follows its own rules. These other types of benefits do not automatically qualify you for SSDI or SSI. The SSA will conduct an independent review of your condition, even if another agency has already deemed you disabled.

6. Lack of a Formal Diagnosis

Having a diagnosis is not always enough to qualify for disability benefits. While medical records and a diagnosis are crucial, the SSA is more interested in your functional limitations. They want to know how your illness or injury affects your ability to work. Conversely, not having a specific diagnosis does not automatically disqualify you. What matters is whether your symptoms limit your ability to work.

7. Personal Challenges or Non-Medical Stressors

The SSA does not consider personal life challenges in the evaluation process. This includes family difficulties, divorce, or the emotional strain of unemployment. While these situations can affect your overall well-being, the SSA is focused on medically determinable impairments and their impact on your work capacity, not on non-medical life circumstances.

8. Partial Disabilities

The SSA’s standards are strict, and they only approve claims for individuals who are unable to engage in substantial gainful activity. If you can work part-time or in a limited role, the SSA may deny your claim, even if your condition significantly impacts your ability to perform your usual job.

9. Effort and Hard Work

Unfortunately, the amount of effort and hard work you’ve put into overcoming your disability or trying to stay employed is not a factor in the SSA’s decision. The SSA’s focus is on your current physical or mental capacity, not on how much you’ve fought to keep your job or improve your condition.

Ortiz Law Firm Can Help with Your Social Security Disability Claim

Navigating the Social Security disability claim process can be confusing. If you’re struggling to understand the SSA’s requirements or need help with your claim, the Ortiz Law Firm can help. Contact us today to discuss your case and how we can assist you with the application or appeal process.