Word Street Journal

SSDI claims heavily depend on medical documentation. If you have comprehensive and accurate medical records, your chances of approval increase. Adding up seeking legal assistance, such as hiring a disability attorney, can further amp up that chance. 

But how do you determine rare diseases? And is fibrous dysplasia a disability too? Rare disabilities or diseases, including dysplasia, are often determined after a comprehensive assessment by healthcare professionals such as physicians, specialists, and diagnosticians.

In this discussion, we will walk you through the steps you need to take, outline the specific conditions and symptoms for an individual with that rare disease to qualify for SSDI benefits, and the strategies you can employ to increase your chances of success.
Understanding SSDI and Its Benefits

SSDI, or Social Security Disability Insurance, is a federal program that offers financial support to people who are unable to work due to a disability. Unlike other disability programs, SSDI isn’t based on financial need but rather on your work history and the severity of your disability.

One of the main benefits of SSDI is the financial assistance it provides. If you qualify for SSDI, you’ll receive a monthly payment that’s based on your average lifetime earnings. This payment can help you cover your living expenses, such as rent or mortgage payments, utility bills, food, and medical expenses. It can provide a sense of financial security and stability during a time when you may be unable to work and earn a regular income.

Aside from financial assistance, SSDI also offers other forms of support. For example, after receiving SSDI benefits for two years, you become eligible for Medicare, which can help cover your medical expenses. SSDI also provides access to vocational rehabilitation services, which can help you develop the skills and abilities needed to return to work if your condition improves.

Identifying the Eligibility Criteria

The Social Security Administration (SSA) follows specific guidelines to assess eligibility for Social Security Disability Insurance (SSDI) benefits. These guidelines involve evaluating various aspects to determine if an individual qualifies for financial assistance due to a disability.

• You must have a medically determinable impairment, meaning your rare disease must be diagnosed by a medical professional and supported by medical evidence. This evidence should include medical records, test results, and doctor’s opinions.
• Your rare disease must significantly limit your ability to work. The SSA evaluates this by assessing your functional limitations and determining if you can perform any substantial gainful activity (SGA). If your rare disease prevents you from earning a certain amount of income, you may be considered eligible.
• Your condition should be expected to last for at least 12 months or result in death.
• You must have earned enough work credits by paying into the Social Security system through your employment. The number of work credits required depends on your age at the time you became disabled.

Gathering and Organizing Your Medical Documentation

To gather and organize your medical documentation for SSDI, you’ll need to collect all relevant medical records, test results, and doctor’s opinions that support your rare disease diagnosis. You can start collecting your medical documentation by:

1. Contacting your healthcare providers to request copies of your medical records, including any hospital stays, surgeries, or specialist visits related to your condition. Make sure to obtain all pertinent test results, such as blood work, imaging scans, and genetic testing, as these can provide objective evidence of your rare disease. 
2. Gathering any supporting documents from your healthcare team, such as letters or notes stating their professional opinion on your condition and its impact on your ability to work.

To ensure organization, create a dedicated folder or binder to keep all your medical documentation in one place. Label each document clearly and maintain a chronological order, making it easier to reference specific information if needed. If you have a large number of documents, consider using dividers or tabs to create sections for different types of records.

Keep a record of any ongoing treatments, medications, or therapies you’re undergoing for your rare disease as well. This information can demonstrate your continued efforts to manage your condition and the impact it has on your daily life.

The Application Process

Once you have gathered and organized your medical documentation, it’s time to navigate the application process for SSDI. The application process can be complex and overwhelming, but with the right information and guidance, you can successfully go through it.

1. You’ll need to complete the application for Social Security Disability Insurance (SSDI). This can be done online, by phone, or in person at your local Social Security office.
2. Make sure to provide accurate and detailed information about your medical condition, work history, and any other relevant information.
3. After submitting your application, you’ll need to wait for a decision from the Social Security Administration (SSA). This can take several months, so it’s important to be patient. 
4. During this time, the SSA may request additional information or medical records to support your claim. Respond immediately and provide any requested documentation.
5. If your initial application is denied, don’t lose hope. You have the right to appeal the decision. The appeals process includes several stages, such as reconsideration, a hearing, and further appeals if necessary. 

It is highly recommended to seek legal representation or assistance from a disability advocate to help you handle the appeals process effectively.

Appealing a Denied SSDI Claim

If your initial application for SSDI is denied, don’t lose hope – there are steps you can take to appeal the decision. It’s important to remember that denial isn’t the end of the road. The Social Security Administration (SSA) provides an appeals process that allows you to present additional evidence and arguments to support your claim.

1. Request reconsideration. This involves submitting a written request to the SSA within 60 days of receiving your denial letter. During reconsideration, your claim will be reviewed by a different examiner who’ll reevaluate your medical and non-medical evidence. It’s crucial to provide any new or updated information that may strengthen your case.
2. If your claim is denied again during the reconsideration stage, you can then request a hearing before an administrative law judge (ALJ). This is the next level of appeal and allows you to present your case in person. It’s highly recommended to have legal representation during this stage, as an attorney can help organize your evidence, prepare you for questioning, and advocate for your rights.
3. If the ALJ denies your claim, you can further appeal to the Appeals Council, which reviews ALJ decisions. Finally, if necessary, you can take your case to federal court.

Conclusion

Qualifying for SSDI with a rare disease requires understanding the eligibility criteria, gathering and organizing medical documentation, and navigating the application process. You have to be thorough and persistent throughout the process. If your initial claim is denied, don’t give up; instead, be prepared to appeal the decision.

Remember, obtaining SSDI benefits can provide crucial financial support for individuals living with rare diseases, and seeking assistance from legal professionals or disability advocates can enhance the likelihood of a successful application and approval.