 SSDRC What is the Application Process for Social Security Disability and SSI? How do you Win Benefits under Social Security Disability or SSI? If I am determined disabled, how far back will Social Security pay benefits? How do you prove your disability case if you have a mental condition? What Can I Do to Improve My Chances of Winning Disability Benefits Common Mistakes after Receiving a Denial of Social Security Disability or SSI Benefits How to File for Disability - Tips for Filing If You Get Approved For SSDI Will You Also Get Medicare? How much does a Social Security disability attorney get paid? Social Security Disability SSI Criteria and the Evaluation Process How long does it take to be approved for SSI or Social Security disability? What do you Need to Prove to Qualify for Disability Benefits? Social Security Disability SSI and Fibromyalgia Social Security Disability SSI and Degenerative Disc Disease Can I Qualify For Disability and Receive Benefits based on Depression? Answers to questions about SSD and SSI disability What Disabilities Qualify for SSI and Social Security Disability Benefits? Social Security Disability Status Social Security Disability Tips — how a claim gets worked on Social Security Disability, SSI Disability - Terms, Definitions, Concepts |
How Does Social Security Disability Make its Decision on a case?How to prove you are disabled and win disability benefits Disability examiners who make decisions for Social Security will reject or deny a claim based on two main criteria: 1) Does the applicant have a serious, ongoing physical or mental condition (with no expectation of improvement over a period of 12 months); and 2) Does the applicant’s condition prevent him from performing past work, or any other work, given his work history and current limitations. In order to determine the severity and nature of an applicant’s medical condition, a disability examiner requests medical records from all medical treatment sources listed on the disability report form that is completed at the time of application. If you are filing for disability, be sure to include the correct contact information for all individuals or facilities from which you have received medical treatment. Disability examiners sometimes have to request records from physicians repeatedly before receiving them, and the process is only delayed further when they are working with incorrect addresses or phone numbers. After receiving your medical records, a disability examiner will review them and determine if your condition meets a listing in the official disability book of impairments, “Disability Evaluation under Social Security.” This book is commonly referred to as the “blue book,”, the listing book, and the "social security disability list of impairments. It lists criteria that must be met to establish that the applicant has an impairment that Social Security recognizes as a disability. There are listings for both children and adults, and some claims are approved on the basis of meeting a listing alone, though this is not typical. When a disability application is approved, it is because, although the individual does not have a condition that meets any of the listings, the limitations caused by his physical or mental condition are such that he is unable to participate in substantial, gainful employment. Approvals that are granted on this basis, rather than on the basis of meeting a blue book listing, are called medical vocational allowances. Before approving a medical vocational allowance, the disability examiner must determine your residual functional capacity. The residual functional capacity evaluation is a form that lists specific physical or cognitive tasks that you are still capable of performing, based on the information in your medical records. After determining your RFC, the disability examiner looks at your particular medical vocational profile with the purpose of determining if you are still capable of performing work, either at a job you have performed in the past 15 years, or a job that you could be expected to perform given your job skills, age, education, etc., and at which you could earn at least the current substantial gainful activity (SGA) amount each month. You will be approved for SSD or SSI if a disability examiner or judge decides that your condition is severe enough to prevent you from performing past work or any other work, but this is not an easy hurdle to pass. “Other work” can be any type of work, even if this job is not really an option in your particular state or locality. A large percentage of applications and reconsideration appeals are denied by disability examiners based on the claimant's ability to perform “other work”. However, the chances of approval rise at the level of a disability hearing held by an administrative law judge. That is why it is important for those who are truly in need of disability benefits to continue to appeal until they have the chance to appear in person before a judge. Over half of all disability denials are overturned by disability judges. 
Return to: SSDRC, or the Questions, Answers, Tips, and Advice page Individual Questions and Answers SSD and SSI are Federal Programs The title II Social Security Disability and title 16 SSI Disability programs operate under federal guidelines and, therefore, the program requirements--medical and non-medical--apply to all states: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming Recent approval and denial statistics for various states can be viewed here: Social Security Disability, SSI Approval and Denial Statistics by state Special Section: Disability Lawyers and unnecessary claim denials |