Overview of Disability
Disability Back Pay
Requirements for Disability
Applications for disability
Tips and Advice for Disability Claims
How long does Disability take?
Winning Disability Benefits
Common Mistakes after a Denial
Mental Disability Benefits
Denials for Disability
Appeals for denied claims
Disability Benefits from SSA
Child Disability Benefits
Qualifications and How to Qualify
Working and Disability
Disability Awards and Notices
Disability Lawyers, Hiring Attorneys
Social Security List of Conditions
What Social Security considers disabling
Medical Evidence and Disability
Filing for Disability Benefits
Eligibility for Disability Benefits
SSD SSI Definitions
SSDRC authored by Tim Moore
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Criteria for how Social Security Disability is Awarded
Many individuals who apply for Social Security Disability (SSD) or supplemental security income (SSI) are turned down for benefits. In fact, statistics show that about 70 percent of all initial claims for disability are denied, and those that are denied are no more likely to be approved if they file a new application unless they have significant new medical evidence to add to their file, or if their initial claim was denied on a technicality; e.g., they earned too much income, the total value of their personal assets was too great when they filed the first time, etc.
However, there is a way that individuals who are turned down for disability can improve their chances of being awarded SSD the next time around, and that is to take advantage of the disability appeals process.
If your initial claim is denied, you should immediately file a request for reconsideration with DDS (the Disability Determination Services agency that makes all disability decisions for the social security administration). This first appeal is highly likely to be denied as well (about 80 percent of them are), but it is worth the effort because after a reconsideration appeal, a claimant can request a hearing before an administrative law judge (ALJ).
For those who have been denied disability by DDS, this hearing is the best chance they have of receiving a favorable decision. The House Subcommittee on Social Security has reported that over 60 percent of all cases heard by ALJs result in the disability examiner’s denial being overturned, and the claimant being approved for benefits.
All disability adjudicators (DDS examiners and judges) decide disability cases based on three basic criteria: 1) the claimant can demonstrate, through medical documentation, that they have a physical or mental impairment; 2) that medical symptoms associated with their condition are severe enough to prevent them from participating in substantial gainful activity; and 3) that their medical condition is ongoing, and has lasted or is expected to last for at least 12 months.
It is impossible to prove any of the three criteria without solid medical evidence, so claimants should take care to supply the social security administration with a detailed medical history that includes names, addresses, and contact numbers for all medical facilities and physicians from which they have received treatment. Without this information, the DDS disability examiner will have difficulty requesting medical records from your physician (s), and this can significantly delay a decision in your case.
After receiving the medical records, the examiner will review them and form an opinion about the claimant’s residual functional capacity (RFC), or what activities the claimant is capable of performing given their current medical condition.
The examiner will then go over the work history that the claimant supplied to social security to see if it is possible to perform a past job or any other type of work to which the claimant may be suited, taking into account their age, education, skill set, etc. For this reason it is critical that those applying for disability provide a work history that is every bit as detailed as their medical history. This should include all places and dates of employment, and all positions/titles held (as well as the job duties associated with those positions) for the past 15 years.
By filing detailed medical and work histories and taking full advantage of the appeals process, disability claimants can greatly improve their chances of, eventually, being awarded social security disability.
Return to: Social Security Disability Resource Center, or read answers to Questions
When does social security consider you eligible for disability benefits?
Who is eligible for SSI Disability?
Disability Criteria - Eligibility For Social Security and SSI Disability
Can I Be Eligible For SSI And Social Security Disability At The Same Time?
Social Security Disability and SSI Mental Claims and Criteria
Can you apply for disability on the basis of multiple health problems?
What makes a person eligible to receive disability benefits?
Inability to Work and Eligibility for Social Security Disability and SSI Benefits
What makes you eligible for Social Security Disability or SSI?
If You Are Currently Working Are You Eligible To Receive Social Security Disability Benefits?
Will Being A Veteran Affect Your Eligibility And Chances For Social Security Disability?
Are SSD and SSI disability cases decided the same way in terms of Eligibility?
Is the Medical Criteria to Get Social Security Disability or SSI Benefits hard?
Criteria for how Social Security Disability is Awarded
Social Security Disability SSI Criteria and the Evaluation Process
Information on the following topics can be found here: Social Security Disability Questions and in these subsections:
Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI
These pages answer some of the most basic questions for individuals who are considering filing a claim.
Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
How to Apply for Disability - What medical conditions can you apply and qualify for?
Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
What happens if I file a disability application and it is denied by a disability examiner or Judge?
How to Prove you are disabled and qualify to win disability benefits
How do you prove your disability case if you have a mental condition or impairment?
Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria