 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 |
What are social security disability denials based on, your medical or work history?How to prove you are disabled and win disability benefits 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) and hopefully, 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: SSDRC, or the Questions, Answers, Tips, and Advice page 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 |