If you have a physical or mental disability that prevents you from earning a living in South Carolina you may be able to obtain disability benefits provided by the federal government’s Social Security Administration (SSA). Many applications for benefits are disqualified initially because applicants do not provide enough evidence of the symptoms of their medical condition and how it prevents them from working. Before you apply for SSDI or SSI benefits you should learn about the medical requirements for social security disability in South Carolina to avoid disappointment.
The SSA uses specific medical criteria outlined in its Blue Book to assess whether an applicant for disability benefits is eligible.
Understanding the SSA’s Blue Book
What is the Blue Book?
The SSA’s Blue Book contains details of all the medical conditions which the SSA considers as disabilities serious enough to be eligible for benefits. The Blue Book is divided into 2 parts, one for adults and the other for children (younger than 18). The adult part is further divided into 18 sections which describe the different categories of eligible disabilities and what evidence is required to satisfy eligibility. The children’s part of the Blue Book has the same 18 sections plus an additional section relevant to their age group.
The Blue Book, together with medical documentation provided by the applicant, is used by SSA’s examiners to decide whether a disability is serious enough to prevent the applicant from working for at least the next 12 months, which is one of the main conditions needed for an applicant to obtain disability benefits.
Medical Documentation Needed to Support Your Claim in South Carolina
Types of Medical Records to Submit
It is not enough to state that you have a serious disability that prevents you from working. You must be able to provide medical documentation which supports your claim for disability benefits. Note that South Carolina’s medical requirements for disability benefits are no different than those for any other state, because both SSDI and SSI benefits are controlled by a federal, not a state agency. The following are the most common types of medical evidence that applicants might have to provide to support their claim:
- doctor’s assessment and notes;
- history of the development of the disability, including original diagnosis;
- records of tests, scans, and x-rays;
- hospitalization records and summary of surgery performed to date, if relevant;
- medication and treatment methods used;
- prognosis for recovery;
- ongoing treatment while application is being assessed.
How to Strengthen Your Medical Evidence
The SSA’s examiners will take into consideration how detailed is the medical documentation provided. The closer the evidence provided by medical professionals and healthcare providers matches the relevant listings in the Blue Book, the more likely an application will be approved.
The SSA will also take into consideration whether you are providing evidence that you are keeping up with treatment for your disability in South Carolina, even if you have already applied for benefits.
Importance of Following Treatments & Follow-Up Care in South Carolina
Importance of Ongoing Treatment
Evidence to show a continued sequence of medical treatment and that this is ongoing is important to prove that you are eligible for disability benefits. Unless you have experienced significant side effects, a failure to keep up with prescribed treatments or medication may result in an application being denied.
Proving Long-Term Disability
South Carolina medical disability requirements are dependent on proving your ongoing inability to earn a living. Applications that cannot show that the applicant is unable to work for the next 12 months at least are likely to be rejected. Long-term disability benefits are also dependent on periodically providing evidence of treatment received and your disability continues to prevent you from working and earning a living.
Consultative Exams & Their Role in the Evaluation Process
What is a Consultative Exam?
If the SSA’s examiners decide that there is still insufficient evidence to support an application for disability benefits based on inadequate medical documentation, they may request you attend a consultative examination. This is when the SSA’s own medical professionals examine you and ask you questions or carry out any further tests to help decide on eligibility.
Preparing for a Consultative Exam
If you have been scheduled for a consultative examination, it is wise to prepare in advance. You should have details of how your condition developed, what you have done to get it treated, and how it has had a negative impact on your daily life, including your ability to stay in a job or be able to keep working. It is important to remain honest throughout the examination and answer any questions you are asked as clearly and fully as possible.
Receiving Benefits if You Don’t Meet Medical Requirements in South Carolina
How to Qualify with Unlisted Conditions
Even if the symptoms of your disability do not match a condition listed in the Blue Book, you may still be able to obtain disability benefits through a medical-vocational allowance. An allowance may be provided if it can be shown that your disability is severe enough as other listed conditions.
Medical-Vocational Allowances
Medical-vocational allowances are benefits that may be offered if a disability can be shown to be preventing the applicant from working for at least 12 months, taking into consideration a grid or matrix which the SSA uses to assess how the disability affects the ability to work based on a combination of the applicant’s age, education, skills and previous work experience.
Additional Medical Information in South Carolina
There are no disability benefits specifically provided by the South Carolina state government. The state does not mandate short-term disability insurance for employees as some other states do. Some employers do carry short-term disability insurance which can be claimed if you become disabled temporarily, even if the disability was not a result of an injury or illness that happened at work.
Working with a South Carolina Disability Lawyer
You may find that your application for disability benefits is made easier if you work with a South Carolina disability lawyer. A lawyer can help with accessing more medical evidence that supports your claim which could be necessary if your application is denied and you decide to appeal the decision.
