Woman sitting with SSDI attorney

What Medical Conditions Qualify Someone for SSD Benefits?

Nobody wants to be dependent on the government to make ends meet. But when medical conditions prevent you from working, few other options exist. 

Social Security Disability (SSD) exists to provide for those unlucky few who are incapable of making a living due to a medical condition. But because it is a government program, there is a lot of red tape involved with getting SSD benefits.

The first requirement is having a condition that qualifies. Not all medical conditions that limit your ability to work will qualify you for SSD. And some conditions may qualify you only if you put in the extra effort. When navigating SSD, it is best to get advice from a disability attorney.

Social Security Maintains a List of Qualifying Conditions

The Social Security Administration (SSA) maintains a list of conditions that qualify for SSD. This list includes:

  • Immune system disorders
  • Mental disorders such as depression or autism
  • Musculoskeletal problems
  • Impaired vision, speech, or hearing
  • Respiratory dysfunction
  • Neurological disorders like epilepsy
  • Blood disorders
  • Cardiovascular conditions

If you have one of the conditions on this list and it impairs your ability to work, you qualify for SSD. This list is specific to adults. Children can also qualify and have a nearly identical list that also includes growth impairment.

Proving Your Condition Qualifies

Just because you know you have a medical condition that qualifies, that doesn’t mean the SSA is aware. To receive SSD benefits, you need to prove that your condition qualifies.

To prove your condition qualifies, you will need a physical examination from a doctor. An examination from your personal physician is usually sufficient to prove that your condition exists but may not be sufficient to prove it impairs your ability to work. For the latter, you will likely need to be examined by an independent physician.

No matter who is examining you, the more evidence you can provide to the SSA, the better. The best evidence comes from the results of tests like:

  • MRIs
  • CAT scans
  • X-rays
  • Blood work panels

Unlike the opinion of a doctor or therapist, this type of evidence is more difficult to refute.

Medical Conditions Not on the List

If you have a medical condition that isn’t on the approved list, you may still qualify for SSD benefits. However, to do so, you have more work to do.

The main hurdle is that you need to prove that your medical condition significantly limits your ability to work. A doctor will test your capacity to function for extended periods to determine this. 

These tests are both for active work and sedentary work. Thus, if you can effectively sit at a desk for eight hours a day, it doesn’t matter that you can’t perform physical labor for that period.

If the tests reveal that you have minimal or no ability to work for extended periods, then it doesn’t matter if your medical condition is not on the official list. That is all of the proof you need that your medical condition qualifies you to receive SSD benefits.

Appealing a Decision by Social Security

Even if you should qualify, you might be turned down for benefits by the SSA. If this happens, you can appeal the decision. Before you appeal any decision, you should hire an experienced Social Security attorney.

Social Security attorneys are familiar with what evidence is most likely to get you benefits and know how to navigate the system. Your chance of succeeding on an appeal is much higher if you have a Phoenix, AZ, disability attorney from Roeschke Law, LLC, representing you. Get in touch with our office today.

Older woman upset about being scammed

Social Security Scams and How to Avoid Them

Scam artists can strike anyone, young or old. New scams are being reported all of the time and are becoming more sophisticated. Social Security scams are well-documented. With millions of people each year receiving benefits, it’s not surprising that these people become victims.

The most common tactic is for a scammer to impersonate someone who works for the Social Security Administration (SSA). The goal of any contact made by a scammer is to obtain and then exploit legitimate Social Security numbers and personal information. 

Common Ways Scammers Make Contact

There are several ways in which scammers will try to trick you into giving them your information. Most often, they will reach out to you as if they are a government employee. They may even have some of your information that makes them seem to be more legitimate. 

Common ways a scammer will contact you include:

  • Phone calls that warn of improper Social Security activity and threaten jail time or fines
  • Friendly phone calls trying to sell SSA services
  • Phishing emails that appear to be from the SSA
  • Fake letters that purport to be from the SSA

At times, it can be difficult to determine what is fake and what is real when it comes to scammers and their artistry. They set out to be deceptive and are quite adept at seeming legitimate.

Ways to Recognize a Scam

There are certain times the Social Security Administration may reach out to you by phone, but telltale signs can let you know when a caller is not with the SSA. When Social Security makes contact, they will never:

  • Make any kind of threat to you
  • Ask for your Social Security number
  • Suspend your Social Security account or number
  • Require that you make an immediate payment
  • Ask for payment by cash, wire transfer, prepaid debit card, or gift card

Social Security may also contact you by email or text messages to make you aware of certain services. SSA will never ask you to return a phone call to an unknown number. 

What to Do if You Suspect You Are on a Fake Call

Social Security scam artists can sound convincing. They can give themselves fake but official-sounding titles, some of which are authentic. Some things to keep in mind if you receive a fake phone call include:

  • Be skeptical if someone calls claiming to be from the SSA
  • If you feel uneasy, simply hang up the phone
  • Call Social Security customer service at 800-772-1213 to ask if someone was trying to reach you
  • Do not click on any email links in a purported SSA email

You may not always know when you’re giving information to a scammer. Following the above tips can help you avoid the unintended consequences of sharing your information with someone whose intention is to exploit your identity.

What to Do if You’ve Been Scammed

If you think you have been the victim of a Social Security scam, you should report it immediately. Call the customer service line listed above and they can connect you with the SSA Office of Inspector General Fraud. You can also report the scam at oig.ssa.gov.

Other steps to take include:

  • Set up credit monitoring — banks sometimes provide this service for free
  • Place a credit freeze on your account with the all credit reporting agencies
  • Place a fraud alert on your credit report — this requires businesses to contact you if someone tries to open an account
  • Contact a Social Security attorney

Roeschke Law in Phoenix, AZ, handles Social Security disability claims. If you receive SSA benefits and have been the victim of fraud, call today.

Injured Man Filling Insurance Claim Form

How Chronic Pain Is Evaluated in Social Security Disability Claims

Chronic pain can make everything about your life more difficult, from working to taking care of your family and even preparing a meal. Many people with chronic pain may seek disability benefits from the Social Security Administration (SSA), only to be denied. 

If this has happened to you, an experienced legal team may be able to help you get the benefits you’re entitled to. Read on to learn about the process of collecting SSA disability benefits.

Qualifying for SSA Disability Benefits

The SSA has a list of medical conditions and injuries that automatically qualify an individual for benefits, but unfortunately, a state of chronic pain is not one of them. Instead, even if the pain is debilitating enough to impact your ability to work, you must prove that the pain stems from an underlying medical condition that the SSA covers.

Medical conditions that cause chronic pain listed in the SSA Blue Book of qualifying disabilities include:

  • Inflammatory Bowel Disease (IBS)
  • Back and spinal injuries
  • Inflammatory arthritis
  • Neurological disorders
  • Somatoform disorders
  • Chronic renal disease or kidney failure

To support your claim with the SSA, you’ll need to have your medical condition verified, including medical records, X-rays, tests, documented results of a physical exam, and a diagnosis from one or more doctors. If you have a second opinion that diagnoses you with the condition, that will bolster your SSA disability claim.

Can I still get benefits even if I don’t meet the SSA criteria?

Even if you don’t meet all of the criteria in the SSA Blue Book, you may still qualify for partial benefits if you can prove that your condition prevents you from working. The SSA will then assess your highest functioning capacity to determine whether you’re capable of performing any work at all.

The Residual Functional Capacity (RFC) assessment determines the persistence, intensity, and other effects of your pain, including:

  • The location, intensity, and frequency
  • Any factors that make the pain worse
  • Whether your pain management regimen or medications can alleviate pain

The assessment covers work-related tasks, including standing, sitting, walking, and remembering information, as well as the impact of your pain on your ability to complete these tasks. If the assessment indicates that you’re unable to complete essential, basic job functions, then you may qualify for benefits.

Establishing Your SSA Disability Case

Your credibility goes a long way toward the outcome of your case. You’ll be asked about your abilities to complete daily activities, from bathing and grooming to caring for your children, cleaning your home, or preparing meals and shopping for groceries. You’ll also be asked for a list of things that you can accomplish on your own, even if you need modifications, such as a wheelchair or frequent breaks.

Whether you sought medical treatment or not is also important in establishing your eligibility for benefits. The SSA may not believe that you’re suffering from severe pain if you haven’t been to the doctor for help.

A Social Security Disability Lawyer Can Help

Obtaining benefits if you’re living with chronic pain can be difficult. You’ll need plenty of evidence to build your claim if the SSA initially denies it. We can help. 

Roeschke Law, LLC of Phoenix, AZ, is a team of Social Security disability attorneys fighting to protect your rights and get you the benefits you deserve.

We work with you through every step of the process and help you find medical professionals in your area who understand the underlying medical conditions that cause chronic pain. 

Call Roeschke Law today or visit us online to learn more and schedule a free legal consultation.

Man meeting with SSD lawyers

Do You Need a Lawyer to Receive Long-Term Disability Benefits?

Long-term disability (LTD) insurance protects you from losing your income if you become unable to work due to an injury or chronic health condition. You may choose to participate in a group plan offered through your employer or purchase insurance on your own.

While this type of insurance benefits many people, filing a claim can be complicated, and having one denied can make a difference in whether you can pay your bills each month. A long-term disability lawyer may be able to help you in several different ways.

Lawyers Help You Understand Your Policy Better

Insurance policies can be challenging to understand, but a lawyer can help you figure out the terms of your policy and what your long-term disability will qualify you for, as well as any deadlines, restrictions, and conditions the policy contains. 

If they determine that you meet the policy’s conditions for benefits, they can also advise you about what evidence the insurance company will need to support your claim. They’ll also note any potential pitfalls as you file your claim and help you avoid them.

Lawyers Ensure You’re Compliant with Disability Laws

The federal law regulating long-term disability claims, the Employee Retirement Income Security Act (ERISA), applies if you’re claiming your long-term disability benefits through your employer. It’s a complicated system of statutes and often favors insurance companies, making it challenging to navigate on your own.

For example, if your initial claim is denied, a lawyer can examine your case and help you appeal it in court or avoid common mistakes that get a claim denied in the first place. 

You may also need to submit certain paperwork at specific times throughout your filing process, which a lawyer can help you collect and submit before the deadline, keeping your case on track.

Lawyers Hold Insurance Companies Accountable

Insurance companies may try to deny your claim or argue that your disability is more minor than it is in reality. Or, they may drag their feet processing your claim or fail to follow all government regulations. A lawyer who understands the nuances of insurance law will make sure the insurance company is following the rules when processing your claim.

Your disability attorney will document any violations of your rights by the insurance company and may even pursue legal action against them if they don’t comply. Once an insurance company realizes you have a legal advocate on your side, they’ll often process your claim quickly to avoid a lawsuit or going to court.

Long-Term Disability Lawyers Work for You

Handling the long-term disability claims process, especially if you’re recovering from an injury or managing a chronic, painful health condition, can be difficult on your own. The claims process is lengthy, and responses from the insurance company may be filled with legalese that you don’t understand. Your disability lawyer takes the legal burden off your shoulders, allowing you to heal.

At Roeschke Law, LLC, we handle the entire disability claims process for you, from completing the initial filing to gathering the appropriate evidence and hiring expert witnesses to examine you or testify on your behalf. 

We’ll also handle communication with the insurance company, including drafting responses for you and making sure that they’re in complete compliance with federal guidelines. Our legal team is committed to getting you the benefits you’re entitled to.

Living with a long-term disability is difficult, but getting your monthly benefits doesn’t have to be. Call us at Roeschke Law in Phoenix, AZ, today or complete our online contact form to discuss the circumstances of your case or appeal.

Man filling out SSD application

When Should You Reopen an SSDI Claim?

If you’ve applied for Social Security Disability Insurance (SSDI) benefits and had your claim denied, you have only a small window of time to appeal the decision and review your claim. If you miss the deadline or decide that you don’t want your claim reviewed, the Social Security Administration (SSA) closes your case.

However, you may still have a chance to receive your disability benefits, even if your initial claim was denied. An experienced Arizona Social Security and disability lawyer can help you explore your options and ensure that your rights are protected.

What are the reasons to reopen a disability claim?

People who receive disability benefits typically receive back pay to the date of the initial application, so it’s often in your best interests to reopen an existing claim rather than file a new one. Many people who successfully appeal their claim will receive a higher amount of back pay.

When can I reopen my Arizona SSDI claim?

In order to reopen a claim, the SSA requires that any changes be related to the new, current claim. For example, if the condition that prompted you to file the initial claim worsens, then you may reopen the claim. 

However, if you have an entirely new medical condition or disability, then you will need to file a new claim. If the two disabilities aren’t related, the SSA won’t reopen the prior claim.

Your ability to reopen the claim also depends on when you filed the first claim. The onset of the second disability must have occurred within the timeframe covered by the first claim.

Reopening the Claim Within 12 Months of the Decision

If you’re reopening a claim within 12 months, you may reopen it for any reason, including if your initial claim was denied by an administrative law judge or the Disability Determination Services.

It’s more difficult to reopen an SSDI claim after 12 months have passed, and you may benefit from legal representation.

Reopening a Claim Between 12 Months and Four Years Later

These claims can only be reopened if the SSA determines there is reasonable cause. The two chief reasons that a claim in this timeframe will be reopened are if there is new, material evidence not available when the initial claim was filed, or if there was a clerical error that resulted in an incorrect determination.

Reopening a Claim More than Four Years Old

It’s very rare that a claim denied more than four years in the past will be reopened. This would only happen, for example, if a witness made false statements, if the claimant was declared dead and was later found alive (very unusual), or if there was an error on the face of the decision.

How can I reopen my SSDI claim?

You will need to file a new application for disability benefits and request in writing that your old claim be reopened. Your application needs to state that the onset date of the disability fell within the timeframe of the initial claim, which, for SSDI applications, is 17 months.

Your Social Security lawyer may request a hearing before an administrative law judge to appeal reopening your claim. They may have a medical expert testify or bring forth new evidence that supports your claim.

Do you need an SSDI attorney?

The Social Security appeals process and the statutes surrounding it can be confusing. The legal team at Roeschke Law, LLC, in Phoenix, AZ, can help. We’ll explain your options and whether you have a chance for a successful appeal or not. 

We charge attorney’s fees only if your claim is approved, and we offer a free, no-obligation consultation about your case. Get in touch with our office today.

SSD attorney sitting with client in wheel chair

4 Things You Should Never Say to Disability Doctors

When you apply for Social Security disability benefits, Social Security will require you to schedule a consultative exam. The doctor who provides this exam is supposed to give an unbiased opinion about whether you qualify. 

However, many of these doctors want to continue to receive referrals from Social Security, possibly making them biased against you. Be wary about what you say because you can’t necessarily trust these disability doctors to be unbiased.

1. Never Be Deceptive About Your Condition

Many people will downplay their symptoms when describing their condition. They may do this to keep up appearances or because they’ve learned to downplay their health to fit in socially. 

Whatever reason you might have to minimize your symptoms, this is the absolute worst thing you can do. You need to explain everything you feel and be clear about how it limits your activity.

Conversely, don’t be tempted to exaggerate your condition. Disability doctors are well trained at ferreting out false symptoms or exaggerated conditions. And once they detect a lie, they will be suspicious of anything else you say. Your disability doctor must also inform Social Security if they catch you in any lies.

2. Do Not Reveal that You Have Ignored Doctor’s Orders

Not all treatments work. And sometimes, a prescribed treatment will aggravate a condition rather than mitigate it. When that happens, you are perfectly within your rights to ignore your doctor’s orders — especially if you aren’t able to get new instructions quickly.

However, this is something you never want to tell a disability doctor. Suppose your disability doctor becomes aware that you are ignoring your doctor’s orders. That information will be relayed to Social Security and will be used against you in any disability determination.

3. Avoid Discussing Non-Medical Information with a Disability Doctor

At some point, the Social Security agency will probably delve into your finances, history, and current living arrangements. But this is not information a disability doctor needs to know. 

Your disability doctor should not be asking you questions about personal topics not directly related to your disability. And if they are, politely refuse to answer and redirect them back to the exam.

Similarly, try not to reveal limiting aspects of your living arrangement due to your disability. 

For example, you shouldn’t tell the disability doctor that your condition prevents you from climbing the stairs in your home or that you’re exhausted by climbing the stairs in your home. 

The doctor may note that you could resolve your condition by moving to a new location. Instead, just say that your condition makes it difficult or impossible to climb stairs.

4. Do Not Threaten to Contact a Lawyer

Some disability doctors are not subtle about being biased against you. They may ask very aggressive questions or be obvious about the fact that they doubt the truth of your statements. 

If this happens, you might be tempted to threaten to get a lawyer. Don’t do this. This will only make the disability doctor more antagonistic and might create animosity where none exists.

Instead, if you suspect unfair treatment by a disability doctor, the best option is to simply take careful note of everything they do and say. Remain calm, cordial, and honest, but pay close attention. 

Once the exam is over, immediately contact an Arizona Social Security disability attorney, like the team at Roeschke Law, LLC in Tempe, AZ. A social security disability lawyer can use the information you carefully recorded to impeach the opinion of the disability doctor and appeal a negative decision by Social Security.

social security disability claim

Denied Social Security Disability Benefits? Here Are Your Next Steps

According to the Social Security Administration (SSA), over 70% of applications for Social Security disability benefits are denied every year. What you might not realize, however, is that denial does not necessarily have to end your claim.

SSA provides options for reversing a denial. Through these procedures, you can present new medical evidence and argue against incorrect applications of the law.

Here is some information about your next steps after SSA has denied your claim for Social Security disability benefits.

Grounds for Denial of Disability Benefits

SSA divides denials into two categories. Technical denials happen when SSA has found a problem in your claim. Medical denials happen when SSA does not believe your disability qualifies for benefits.

If you received a technical denial, it means that SSA never reviewed your medical records. Instead, it denied your claim based on a problem with your claim or work history.

If you received a medical denial, SSA reviewed your medical records but found:

  • Insufficient documentation of your disability
  • Your illness or condition did not fit into one of SSA’s listings
  • Your disability does not prevent you from working or training

SSA could issue a medical denial if your doctor failed to conduct one of the tests SSA expects for your condition. Similarly, SSA could issue a medical denial if you worked or earned more than SSA allows. This would show that your condition or illness did not interfere with your ability to work.

Technical denials make up over 37% of denials. This means that you can substantially improve your chances of having your claim accepted if you can avoid technical problems with your claim.

If you can get past the technical review, SSA approves 51% of disability claims. In 2019 — the most recent year reported — SSA approved 529,599 claims for disability benefits.

Next Steps After a Denial

If SSA denies your claim, you have several ways to have your claim reviewed.

Request for Reconsideration

First, you can request reconsideration of your claim. You must request reconsideration within 60 days of the decision to deny your claim.

Reconsideration takes place at the same level as the initial decision. A different disability examiner will review your application and accept or deny the claim. You can submit new medical evidence or correct problems in your claim when you request reconsideration.

In 2019, SSA permitted 12.8% of the claims for which applicants requested reconsideration. But bear in mind that because of the massive number of claims received every year, SSA only allowed 39,612 claims to move forward with reconsideration.

Appeal and Hearing

If you do not receive an allowance for reconsideration, you can file an appeal. An appeal moves one level up from the disability examiners to an administrative law judge (ALJ).

ALJs are usually lawyers trained in Social Security and disability law. Before your hearing, you can submit new medical evidence or make legal arguments against the grounds for denial.

In 2019, ALJs allowed 54.5% of claims that were previously denied. This extraordinarily high rate means that you have a fair chance of getting disability benefits, even if you’ve had two prior denials.

Higher-Level Appeals

If an ALJ denies your claim, you can seek a higher-level review. You can request a review by the Appeals Council. However, you cannot submit new evidence to the Appeals Council. Instead, your request must usually cite a legal error by the disability examiner and ALJ.

The Appeals Council does not accept every case for review. If the Appeals Council accepts a case for review, it can uphold, modify, or reverse the ALJ’s decision. The Appeals Council can also vacate the ALJ’s decision and send it back to the ALJ for a new hearing and decision.

If the Appeals Council denies review or upholds the rejection of your claim, your last option is to file a lawsuit in federal court. Federal court judges must defer to the denial if it is supported by substantial evidence. 

As a result, judges can reverse denials if the ALJ committed a legal error or the record lacked substantial evidence to support the ALJ’s decision.

The Role of the Disability Lawyer

A disability lawyer can prepare your claim so you reduce the risk of a technical denial. This can substantially improve your chances of acceptance. A disability lawyer can also prepare the evidence needed to fight a medical denial during reconsideration or appeal.

To discuss how a disability lawyer from Roeschke Law, LLC can help you after your claim denial, contact us to schedule a consultation today.

Disabled woman with crutches

What Happens If an Original Work Injury Leads to a Second Injury?

Many issues surrounding your Social Security Disability Insurance (SSDI) benefits arise when one injury leads to another. If this happens, you may have concerns about whether you can still get benefits. If you already receive benefits, you might wonder whether you need to reapply with a new injury.

You might also receive compensation for your second injury. You may not know whether to report this compensation to the Social Security Administration (SSA) or how it may affect your SSDI benefits.

With these factors in mind, here is some information about what can happen if you suffer a second injury after an original work injury.

Eligibility for Social Security Benefits

To receive SSDI benefits, you must meet certain qualifications. You must:

  • Work long enough and recently enough to have paid into the Social Security system
  • Have an illness or injury expected to last at least a year or lead to your death
  • Suffer a resulting impairment that prevents you from continuing to work or training for new work

SSA does not restrict benefits to those who suffered a work injury. Any long-term disability that prevents you from working or training will qualify. 

For example, cancer can lead you to become eligible for SSDI benefits, regardless of the cause of your illness.

How to Handle a Second Injury After an Original Injury

Frequently, one injury will cause another. For example, weakness in your legs from spinal stenosis could cause you to fall and suffer a traumatic brain injury. Your chemotherapy treatment could cause peripheral neuropathy.

How you handle the second injury depends on whether you already receive SSDI benefits or become eligible for SSDI benefits based on the second injury.

If You Already Receive SSDI Benefits

If you already get SSDI when you sustain the second injury, your benefits will not change. Your first injury already qualified as a disabling condition and sustaining a second injury will not change that fact.

SSA requires you to report all changes in your medical condition. You should report the second injury to:

  • Satisfy your reporting requirement
  • Create a record of the second injury in case it worsens
  • Preserve the possibility of extending your SSDI benefits

The last point is important. Suppose that your second injury provides an independent ground for meeting the SSDI eligibility requirements. If your original injury improves, you can continue to receive SSDI benefits until the second injury also improves.

You could go even further than simply reporting your second injury. SSA allows you to reapply for SSDI benefits while you are currently receiving SSDI.

If your second injury qualifies as disabling, you should consider reapplying. SSA can reapprove your SSDI benefits for both your original condition and your new condition. That way, if the first condition improves, you continue to qualify for SSDI with the later condition.

If You Do Not Yet Receive SSDI Benefits

If you were not receiving SSDI benefits when you sustained your second injury, you might qualify as a result of your second injury. When an applicant suffers from multiple disabilities, SSA evaluates them based on the cumulative effect of all of the impairments they face.

This means that you could receive SSDI benefits with two injuries if:

  • The original injury qualifies and the second does not
  • The second injury qualifies and the original does not
  • Both injuries qualify independently
  • The cumulative effect of the two injuries leads to eligibility

The only way you would not receive benefits is if the original injury, second injury, and cumulative effect all fail to qualify. You should speak to a lawyer about applying for SSDI benefits after sustaining a second injury for this very reason.

How SSA Will View Compensation for Your Injuries

SSA can reduce your SSDI benefits when you sustain a second injury and receive compensation for it.

Suppose that you sustained the second injury at work and received workers’ compensation for it. SSA cannot pay benefits if the total compensation you receive exceeds 80% of your average earnings. 

If your workers’ comp plus your SSDI exceeds this limit, SSA will cut your SSDI payments.

However, some compensation does not count toward your limit. If you received a personal injury settlement for your second injury, your SSDI benefits will continue unchanged.

Getting Help from a Disability Attorney

A second injury can raise some complicated issues surrounding your SSDI benefits. To discuss how your second injury might affect your eligibility or the amount you receive, contact an experienced disability attorney at Roeschke Law, LLC to schedule a consultation.

social security disability claim

New Conditions Included in the SSA Compassionate Allowance Program

Applications for Social Security disability benefits can take years to wind their way through the system. All the while, applicants suffer from debilitating medical conditions. In addition to what can be chronic pain and discomfort, this benefit applicants also often struggle with loss of income due to the inability to retain gainful work. The stress of such resulting financial strain can be severe. Under certain circumstances, some claimants can put their application on a fast track to approval through the Social Security Administration’s (SSA) Compassionate Allowance program, which has been recently expanded to include even more medical conditions.

New Conditions Included in the SSA Compassionate Allowance Program

Former SSA Commissioner Michael Astrue instituted the Compassionate Allowance program back in 2007. The program was established to help clear through the backlog of cases in the Social Security disability system which was reaching upwards into the thousands. Those in this backlog had often been waiting up to two years to receive a determination or hearing on their applications.

The Compassionate Allowance program is essentially an expedited application process for benefit applicants who have special circumstances. Those suffering from certain conditions can receive benefits assistance in a much more timely manner considering the normal route can be quite lengthy. While a significant portion of the conditions listed as qualifying for the Compassionate Allowance program are rare diseases, some are more common. The list of qualifying conditions has been developed by members of the medical community as well as members of the scientific community. In fact, members of the public are able to suggest conditions that should be added to the list.

Conditions included in the Compassionate Allowance list are considered to not only be serious but difficult to live with. Many of the listed conditions are considered to be terminal illnesses. Part of the justification for including a condition on the Compassionate Allowance list is that these are medical conditions that are very likely to lead to a claimant’s application being approved for benefits.

While the Compassionate Allowance provides a faster, more streamlined application process, there is a process to comply with, nonetheless. You must present evidence of certain facts, particularly relating to your diagnosis of a condition on the Compassionate Allowance list. You will still need to fill out all required paperwork properly and completely as well.

Previously, the list of conditions qualifying for the Compassionate Allowance program sat at 254 conditions. The Acting Commissioner of the SSA, Kilol Kijakazi, however, announced back in August of 20221 that 12 new conditions would be added to the list. The 12 newly listed conditions are:

  • Charlevoix Saguenay Spastic Ataxia (ARSACS)
  • Choroid Plexus Carcinoma
  • CIC-rearranged Sarcoma
  • Congenital Zika Syndrome
  • Desmoplastic Mesothelioma
  • Duchenne Muscular Dystrophy – Adult
  • Pericardial Mesothelioma
  • Refractory Hodgkin Lymphoma
  • Renpenning Syndrome
  • SCN8A Related Epilepsy with Encephalopathy
  • SYNGAP1-related NSIA
  • Taybi-Linder Syndrome

Arizona Social Security Disability Attorney

Do you think you may qualify for the Compassionate Allowance program? Talk to the knowledgeable team at Roeschke Law about your options. Contact us today.

woman with fibromyalgia

Qualifying for Social Security Disability Benefits with Fibromyalgia

Fibromyalgia may be difficult to diagnose, but this disease is very real and the impact it can have on an individual can be truly debilitating. For those suffering from fibromyalgia, maintaining steady, gainful employment may not be possible. These individuals may seek financial support in the form of Social Security disability benefits. With fibromyalgia proving so difficult to diagnose, however, qualifying for benefits may be an uphill, but not impossible, battle.

Qualifying for Social Security Disability Benefits with Fibromyalgia

Fibromyalgia symptoms can closely mirror those of other diseases. Additionally, proper diagnostic testing for fibromyalgia is not always conducted. To compound the difficulty of diagnosing fibromyalgia, there are many self-reported symptoms that are not always visible to those other than the individual suffering from the condition. All of this is to say that insurance companies and those government agencies tasked with distributing disability benefits can view claimants suffering from fibromyalgia with great trepidation.

While difficult, it is still possible to qualify for Social Security disability benefits if you have fibromyalgia. The Social Security Administration (SSA) will want to evaluate your medical condition to see if it equals one of its listings of qualifying medical impairments. If you have a medically determinable impairment and your medical condition prevents you from working in a substantial gainful activity job, you may qualify for benefits.

Because fibromyalgia can be so commonly misunderstood by those in the Disability Adjudication Services office as well as administrative law judges in the Office of Disability Adjudication and Review, the SSA issued Social Security Ruling (SSR) 12-2p to shed light on fibromyalgia as a disabling condition. The ruling defines fibromyalgia as pain in the joints, muscles, tendons, or nearby soft tissue that has persisted for a minimum of 3 months. The ruling requires that for fibromyalgia to be considered a medically determinable impairment, there must be evidence of diffuse chronic muscle pain impacting four quadrants of the body in addition to the spine.

In order to test for fibromyalgia, medical professionals may apply standard pressure to 18 tender points on the body. Should 11 or more tender points to both the right and left side of the body in addition to above the waist yield pain when standard pressure is applied, then a fibromyalgia diagnosis can be issued. SSR 12-2p states that a claimant must not only have a history of diffuse chronic pain but also exhibit six or more repeated fibromyalgia symptoms which may include:

  • Chronic fatigue syndrome
  • Poor restorative sleep
  • Difficulty concentrating
  • Anxiety
  • Depression
  • Temporal-mandibular joint dysfunction (TMD)
  • Chronic migraines or tension headaches
  • Chest pain
  • Nausea
  • Loss or change in taste
  • Irritable bowel syndrome
  • Irritable bladder

Furthermore, SSR 12-2p requires other disorders which may lead to similar symptoms manifesting themselves to be excluded. Adjudicators must take into account the opinions of treating doctors of the claimant as well as other acceptable medical sources including psychologists and psychologists. Additionally, family members and others who know the claimant may make statements that could be informative regarding the establishment of a claimant’s fibromyalgia diagnosis.

Arizona Socal Security Disability Attorney

If you suffer from fibromyalgia and wish to apply for Social Security disability benefits, do not delay in reaching out to Roeschke Law for assistance. We can help you navigate the process, comply with application requirements, and help present the strongest possible case for benefits. Contact us today.