How to File for SSI

How to prove you are disabled
and win disability benefits

Continued from: How to Apply for SSI, Part I

How are medical records used to determine an SSI decision? The disability examiner who has been assigned to process the SSDI or SSI claim will sift through a claimant's records looking for evidence of functional limitations.

Functional limitations may be either physical or mental. If a claim involves either a physical condition or a mental condition, the examiner will rate the claimant's level of restricted functionality (known as their RFC or residual functional capacity, which is defined as what a person can still do despite their overall condition).

Very often, of course, the examiner will assess the claimant's physical RFC and their mental RFC as well since it is common for a disability claim to include both mental and physical allegations.

The residual functional capacity rating that is given to a claimant (For example, in the case of physical impairments, are they restricted from doing anything more than light physical work, or are they restricted from tasks that involve one of their senses such as vision or hearing.

In the case of mental impairments, do they have difficulty with short or long-term memory recall, or do they have difficulty sustaining attention or concentration) is compared to whatever physical or mental capabilities were required of their past jobs?

If their RFC rating (or ratings) is severe enough, the claimant may be judged incapable of going back to their past work, and perhaps incapable of doing any other work for which they might otherwise be thought capable of doing.

Why is it important to produce the medical history prior to the appointment for the disability application interview? Because, just as with the work history, accuracy is very imporant.

Speaking as a former disability examiner, I can state that many claimants fail to give sufficient information about their treatment sources when filing for disability. In some cases, the claimant does not give enough information for the examiner to distinguish one doctor or clinic or hospital from another.

In other cases, the claimant entirely omits the information. And this may be due to the fact that the claimant cannot recall the information during the interview. It may also result from a mistaken assumption that the social security administration can automatically access all of a claimant's medical records simply by having their social security number.

However, this is not the case and many claims are disadvantaged by the fact that the disability examiner does not have access to all of a claimant's records (due to the claimant not providing all of the treatment sources). This phenomenon is often demonstrated by what happens at disability hearings when a claimant's disability attorney suddenly learns of a doctor or clinic that was previously unknown by the social security administration. It is entirely possible that had the information regarding the unknown medical treatment source been known, the claim might have been approved sooner and without the need for filing disability appeals.