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
Are SSI and SSD disability claims denied by social security for lack of evidence?
How to prove you are disabled
and win disability benefits
The basic reason that any social security disability or SSI claim is denied is that there is a lack of medical evidence in the claimant's file that supports an approval. To get a disability claim approved, a disability examiner (examiners make decisions on initial claims and reconsideration appeals) or a federal administrative law judge must have documentation available to them that allows them to do the following:
1. Determine if the claimant's impairment (or various impairments, as is usually the case) is severe or non-severe.
2. Determine what the claimant's functional limitations are. Functional limitations can be either mental or physical. Many claims do, in fact, involve both mental and physical impairments and this requires that the decision-maker on the claim consult with both a medical consultant as well as a psychological consultant (both consultants are part of the disability examiner's case processing unit).
There are instances, of course, in which a claimant has no history of medical treatment, or very little history of recent treatment. In those cases, the claimant will be scheduled to go to a consultative examination. This examination can be a physical examination, an IQ test, a mental status exam, or a full fledged psychiatric examination.
Consultative exams, often referred to a social security medical examinations, are performed by independent physicians and psychologists, not by individuals who are actually employed by the social security administration.
Are disability claims ever won based on the results of a consultative exam? It does happen occasionally. And it tends to happen more often when the exam is mental (such as for memory scale testing, or intelligence testing) versus a physical consultative exam (usually, physical exams last little more than ten minutes and the report provided by the examining physician provides very little useful information for either a disability examiner or a judge). However, in the great majority of cases, consultative exams do not provide the basis for an approval of a social security claim.
Because cases that lack substantial evidence stand a poor chance of being approved by social security, individuals who are considering filing for disability benefits should do the following:
1. If they are not being seen by a doctor, they should begin to get regular treatment. This is the only way that medical records will be generated for the social security administation to obtain and review.
2. If they have a condition that has not been formally diagnosed (such as depression, or anxiety disorder), they should be seen by the appropriate source of treatment (for example, fibromyalgia should be diagnosed by a rheumatologist or a pain treatment specialist, whereas depression should be diagnosed by a mental health professional, ideally a psychiatrist).
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Topics and Questions
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