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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Is a Social Security Disability denial based more on your medical or work history?
Denials on social security disability and SSI disability claims are based on both an individual's medical history and their work history as well.
A claimant's medical records will allow a disability examiner (examiners are the individuals who make decisions on disability claims for the social security administration at an agency known as DDS, or disability determination services) to establish the following facts:
A) A diagnosis, thus an origin, of a condition.
B) A history of corroborative evidence, such as bloodwork, imaging scans (xrays, CT scans, MRIs, ultrasound, etc), physical examination, and special testing.
C) A history of response to treatment, including the claimant's response to prescribed medication.
D) A prognosis of the condition (i.e. where is it all leading to)
E) Indications in the treatment notes regarding the claimant's physical and/or mental limitations so that these limitations can be used to rate the RFC, or residual functional capacity, of the claimant (for the purpose of evaluating the disability claim).
The claimant's work history will allow a disability examiner to determine what a claimant's job skills are and what the demands (both physical and mental) of their past work was. It will also allow the examiner to determine, based on the claimant's age and rated limitations (again, both physical and mental), what other types of work they might be capable of performing if their condition does not allow them to return to one of their former jobs (from within the past 15 years, which the social security administration refers to as the "relevant period").
Because social security disability and SSI disability claims are based on both types of information--from the work history and medical treatment history--the decisions that are reached are considered to be medical and vocational. In fact, the most common type of approval that is made is known as a "medical vocational allowance (most cases that are approved are approved via a medical vocational allowance).
How exactly is a medical vocational allowance granted? In short, this type of approval occurs when the disability examiner (or an administrative law judge if the claim is at the hearing level) has evaluated all of the medical records that have been gathered from all the doctors, clinics, and hospitals that have provided treatment to the claimant.
Using these records, the examiner will gauge what the claimant' residual functional capacity is (the RFC, in simplest terms, is what a person is still capable of doing despite their illness) and then compare the claimant's limitations to what was required of them in their various former jobs.
If the claimant is judged to be incapable of going back to one of their former jobs, the examiner will then consider whether or not their skills and training would allow them to do some type of other work, given the physical or mental limitations that they possess. If the examiner concludes that they cannot switch to some type of other work, they will be awarded a medical vocational allowance.
Return to: Social Security Disability Resource Center, or read answers to Questions
Social Security Disability and cerebral palsy
How much does disability pay?
What does Social Security Disability SSI pay, how much?
Social Security Disability SSI reviews
Temporary Social Security Disability SSI
How to qualify for disability with depression
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