Navigating disability claims for pre-existing conditions can feel like walking through a maze with no clear exit. If you’re dealing with a pre-existing condition that prevents you from working, you may wonder if you even qualify for benefits through the Social Security Administration (SSA).

Nearly 65% of initial Social Security disability claims are denied, often due to insufficient medical evidence or improper filing, according to the Social Security Administration Annual Statistical Report. This highlights how crucial it is to understand the claims process and submit a strong, well-documented application.

The good news? Pre-existing conditions often do qualify—but the process of proving your eligibility can be complicated.

In this article, we’ll walk you through the key considerations for Social Security disability claims. You’ll gain a better understanding of how pre-existing conditions are evaluated, and what steps you can take to strengthen your application. We’ll also cover why you should consider securing the assistance of a disability lawyer during the process.                                        

What Are Pre-existing Conditions?

A pre-existing condition is any medical issue that you had before applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

Common examples include:

• Diabetes
• Heart disease
• Cancer
• Chronic back pain
• Mental health disorders like depression or post-traumatic stress disorder (PTSD)

In the context of Social Security disability claims, the key factor isn’t when the condition began—it’s how severely it limits your ability to work. The SSA is less concerned about the condition’s origin and more focused on whether it prevents you from performing substantial gainful activity (SGA).

Can You Qualify for Disability Benefits with a Pre-existing Condition?

Yes, you can. The SSA doesn’t automatically disqualify applicants with pre-existing conditions. In fact, these claims are common. However, proving that your condition meets the SSA’s definition of a disability requires careful documentation.

To qualify for benefits, you’ll need to show how your condition significantly limits your ability to work. This includes performing basic tasks like sitting, standing, lifting, or concentrating.

You’ll also need to prove that your condition has lasted or is expected to last at least 12 months or result in death. Remember, short-term or temporary conditions do not qualify.

Also, to qualify for benefits you must meet the technical criteria for SSDI or SSI. For SSDI, you’ll need to have a sufficient work history and paid Social Security taxes. For SSI, your income and assets must fall below specific thresholds.

How Does the SSA Evaluate Disability Claims for Pre-existing Conditions?

The SSA uses a five-step evaluation process to determine eligibility:

Are You Currently Working?

If your monthly earnings exceed the substantial gainful activity (SGA) threshold ($1,470 in 2025), your claim may be denied.

Is Your Condition Severe?

Your condition must significantly limit your ability to perform basic work activities. If the SSA deems it “not severe,” your claim won’t proceed.

Does Your Condition Match One Listed?

The SSA maintains a list of impairments (commonly called the “Blue Book”) that automatically qualify as disabilities if you meet specific criteria. If your condition isn’t listed, the SSA will evaluate whether it’s comparable in severity to a listed impairment.

Can You Perform Your Past Work?

The SSA will assess whether you can still perform the work you’ve done in the past 15 years.

Can You Perform Any Work?

If you can’t perform your previous job, the SSA will evaluate whether you can adjust to other types of work based on your age, education, and experience.

Common Challenges with Pre-existing Conditions

When dealing with securing Social Security disability, you’ll often face certain challenges that involve pre-existing conditions. You’ll need to overcome them to ensure that your case progresses smoothly and you secure your disability.

Proving Severity of Condition

Pre-existing conditions often worsen over time, and you must demonstrate that your condition has reached the point where it prevents you from working. Medical records should reflect this.         

Incomplete Documentation

One of the most common reasons for denied claims is insufficient medical evidence. Comprehensive records, including diagnostic tests, doctor’s notes, and treatment plans, are essential.

Confusion About Onset Dates

If your condition has been ongoing for years, determining the onset date can be tricky. The onset date is critical because it affects when your benefits begin.

Prejudice Against Non-visible Conditions

Mental health impairments or chronic pain conditions often face more scrutiny because they’re harder to quantify compared to physical conditions.

How to Strengthen Your Social Security Disability Claim

Below are a few ways to strengthen your Social Security disability claim:

Gather Comprehensive Medical Evidence

Work with your healthcare providers to compile a complete record of your condition. This includes:  

• Doctor’s evaluations         
• Diagnostic tests (e.g., MRIs, X-rays, lab results)     
• Prescriptions and treatment plans        

Include Personal Statements

Write a detailed account of how your condition impacts your daily life and ability to work. Statements from family, friends, or coworkers can also add valuable context.

Follow All Prescribed Treatments

The SSA often denies claims if it appears you haven’t followed your doctor’s recommendations. Document your adherence to treatments, such as attending therapy sessions or taking prescribed medications.       

Seek Help from a Disability Lawyer

A disability lawyer can make a significant difference in the outcome of your claim. They’ll help you navigate the process, gather the right evidence, and avoid common pitfalls that lead to denials.         

Be Persistent

If your claim is denied, don’t lose hope. Many claims are approved during the appeals process, especially with proper legal representation.   

Why Working with a Disability Lawyer Matters

Filing for Social Security disability claims can be overwhelming, particularly for those dealing with pre-existing conditions. A disability lawyer understands the complexities of the system and can advocate on your behalf.                     

Benefits of a Disability Lawyer  

A skilled disability lawyer will provide you with expert guidance during your application process to ensure it’s accurate and complete before submission.  

In addition, lawyers know exactly how to gather and present evidence, such as medical record support.  

If during the process there is a problem and your claim is denied then a lawyer will provide you with appeals assistance and will represent you through the process.         

Without a doubt, lawyers help secure the maximum benefits you’re entitled to under the law.  

Applying for disability claims for pre-existing conditions can be a daunting process, but it’s not impossible. With proper preparation, detailed documentation, and the right support, you can significantly improve your chances of approval.            

Remember, the SSA isn’t just evaluating your condition—it’s evaluating how well you can present your case. That’s why having a disability lawyer by your side can be invaluable.                

Need Help with Your Disability Claim?

If you’re struggling with a Social Security disability claim, let the experienced team at Disability Attorney Services guide you through the process. We specialize in helping individuals with pre-existing conditions secure the benefits they deserve.                     

Contact us today to schedule a consultation and learn more about how we can help you with your Social Security disability claim.