As we provide for ourselves and our families, life sometimes tosses us curveballs in the form of debilitating injuries or emotional difficulties that leave us unable to work and with substantial medical costs. The government created the Social Security Disability Insurance program many decades ago to fill financial gaps created from being put out of work. Short and long-term disability insurance programs provided by employers serve a similar purpose.
Yet many people find themselves denied the peace-of-mind coverage provided under government disability or private disability insurance programs. The programs have strict requirements for eligibility, and even the slightest anomaly can lead to rejection.
If this describes your situation, your first question might be: What conditions are considered a disability? The answer isn't always simple, but the attorneys at Goodman Acker P.C. of Detroit, Michigan, can help guide you through the process.
What Conditions Are Considered a Disability Under SSDI?
The Social Security Administration maintains a list of impairments that by definition are severe enough to put an individual out of work and keep them from other daily activities. This list comprises two parts — one for individuals over the age of 18, one for those under 18.
The adult list is quite extensive and includes criteria for evaluating the particular injury or disorders in the following areas:
- Musculoskeletal, including problems with the spine and upper and lower extremities.
- Special senses and speech, including visual disorders such as abnormalities of the eye, the optic nerve, the optic tracts, or the brain.
- Respiratory, such as chronic obstructive pulmonary disease and other similar conditions that cause restrictions or obstructions of breathing.
- Cardiovascular, such as congenital heart failure and ventricular dysfunction that interfere with proper heart function.
- Digestive, such as gastrointestinal hemorrhage, hepatic (liver) dysfunction, inflammatory bowel disease, short bowel syndrome, and malnutrition.
- Genitourinary and other kidney problems, such as chronic glomerulonephritis, hypertensive nephropathy, diabetic nephropathy, and hereditary nephropathies.
- Hematological disorders, including cancerous and non-cancerous conditions such as hemolytic anemias, disorders of thrombosis, hemostasis, and bone marrow failure and lymphomas.
- Skin disorders, including chronic infections of the skin or mucous membranes, dermatitis, genetic photosensitivity disorders, and burns
- Endocrine disorders, such as thyroid, pituitary, or other glandular conditions.
- Congenital disorders that affect multiple body systems.
- Neurological disorders such as epilepsy, amyotrophic lateral sclerosis, coma, or persistent vegetative state (PVS), or other disorders that cause gross motor dysfunction.
- Mental disorders, a broad category that includes anxiety and depression, eating disorders, autism, personality disorders, or related emotional challenges.
- Cancer, including those classified as malignant neoplastic diseases.
- Immune system disorders such as conditions interfering with antibody production, impaired cell-mediated immunity, a combined type of antibody/cellular deficiency, and impaired phagocytosis.
Other Criteria in Determining Disability
The list of impairments is only one aspect of determining whether you have a disability. You can still be classified as disabled even if you do not suffer from a specific condition on the list. That, however, is dependent on a multi-step review in which evaluators will consider a number of significant questions:
- Are you working?
- Is your condition "severe?"
- Is your condition on the list of disabling impairments?
- Can you do the work you did previously?
- Can you do other types of work?
The program maintains special rules for individuals affected by blindness and may offer benefits for disabled widows or widowers and children.
It is important to note that SSDI only applies in the case of a total disability. The program does not provide benefits in connection with short and partial-term disabilities. However, the program pays benefits to everyone who qualifies, regardless of need.
Determining whether you qualify for disability benefits can be confusing and frustrating. The attorneys at Goodman Acker can help guide you through the process and recommend your best course of action.
Michigan State Disability Assistance Program
Adults with disabilities may also qualify for assistance under the Michigan State Disability Assistance Program, administered by the state's Department of Health and Human Services. If you are eligible for federal disability-related benefits, you are considered disabled for purposes of the Michigan SDA. You will have to substantiate your disability with the appropriate documents.
You also qualify if you reside in a special facility such as a licensed adult foster care home or have been certified as unable to work for at least 90 days due to a mental or physical disability via Department of Health and Human Services contractors.
To receive benefits, you must be a resident of Michigan and a citizen of the United States. Your benefits are income-based and limited by the amount of your total assets.
What About Temporary Disabilities?
In the event of less-than permanent disabilities, Michigan workers face one of several possibilities to fill the income gap created by being unable to work. If their injury or disability occurred at work, employees can file for benefits under the state's worker's compensation program.
If, however, the injury or condition was not related to work, then workers will have to lean on their insurance coverage. They may be able to obtain short-term disability coverage through their employers, or purchase a short-term disability policy on their own in the open market.
Let Goodman Acker Review Your Disability Claim
Life changes drastically when you have a disability, especially if your injury prevents you from working. Unfortunately, sometimes your claims under short- or long-term disability insurance can get denied. If this happens to you, don't go through the complicated appeals process alone. Consulting with an attorney experienced with denied disability claims can increase your chances of success. The attorneys at Goodman Acker P.C. of Detroit, Michigan, have significant experience handling disability claim appeals and understand the rules of the Employee Retirement Income Security Act (ERISA), which sets out the rules of employer-provided group long-term disability insurance.
Goodman Acker attorneys can also help you obtain the benefits you need to provide for yourself and your loved ones under Social Security Disability Insurance Claims. We handle such cases on a contingency fee basis. Reach out for a consultation to share your experience or contact us online today.