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
Ask a question, get an answer
How does Social Security use Evidence to Decide an SSDI or SSI Disability Claim and Make a Decision?
Disability decisions for claims filed with the social security administration utilize a process known as sequential evaluation. Under this system, a disability examiner will essentially review the case to determine if the claimant is capable of engaging in work activity while earning a livable wage (known as SGA or substantial gainful activity).
When a disability examiner at DDS (disability determination services) is working to evaluate and reach a decision on an SSDI (social security disability insurance) or SSI (supplemental security income) case, the examiner will focus on evidence.
The "evidence" includes that evidence which has been supplied by the claimant at the time of applying for disability, and also that evidence which has been further gathered by the examiner from A) medical treatment sources, B) the claimant, C) employers (though this is not usually the case), and D) individuals who know the claimant (this is usually in the form of a third-party contact individual who has been listed by the claimant at time of filing for disability).
The evidence reviewed and evaluated by a disability examiner tends to fall into three types of categories: medical evidence, vocational evidence, and subjective assessments.
Medical evidence on a social security disability or SSI case
This includes all the records that are gathered from the claimant's treatment sources, such as individual physicians, hospitals, and clinics. It will also include the results and reports obtained from any medical examinations that the claimant is sent to. These examinations are known as "consultative examinations". A CE is paid for by the social security administration and is performed by a medical physician, or psychiatrist if the exam is psychiatric in nature, or a psychologist if the exam involves memory or IQ testing.
Vocational evidence on a social security disability or SSI case
This includes all the evidence that pertains to the claimant's work history. This will typically include the information that the claimant has supplied at the disability application interview regarding their past work history, as well as any work activity forms that have been requested by the disability examiner.
It may also involve any information gathered directly from the claimant's former employers (though, ordinarily, disability examiners do not take the time to contact former employers). Lastly, vocational evidence can include the testimony of a vocational expert at a disability hearing if the administrative law judge holding the hearing has determined that it is necessary.
This correlates with information gathered from the disability claimant or from individuals who know the claimant. A good example of this is information obtained that records ADLs, or activities of daily living. To elaborate, very often disability examiners will either phone an applicant or send them them a form to complete that asks about their daily activities.
Examples of the questions that are asked include: "Are you able to cook?", "How do you go about your grocery shopping?", Can you use a vacuum cleaner?", "Can you reach into cupboards?", Can you bend down to retrieve items from cabinets?", "Do you have difficulty with personal hygeine tasks such as bathing?", etc.
The objective of this type of questioning is for the disability examiner to learn whether or not the claimant is experiencing any day-to-day functional limitations. Why are such limitations important? Because these are the same types of limitations that might be reflected in a work environment, meaning that if a person has difficulty picking up a bag of groceries, they might also have difficulty picking up a container or box.
Or if that same individual has difficulty buttoning a shirt due a hand impairment, they might also have difficulty with fine and dexterous movements involving precision tools or even in operating equipment.
Return to: Social Security Disability Resource Center, or read answers to Questions
How does Social Security Decide if I am Disabled?
How Does Social Security Decide How Much I Get For Social Security Disability or SSI?
How Will Social Security Decide a Disability Case that's filed?
Who will decide my Social Security disability claim?
Does Your Doctor Decide If You Get Disability Benefits from Social Security or SSI?
How long does it take to get SSI Disability Benefits?
How does Social Security Disability Decide if you can Work or Not?
How does Social Security use Evidence to make a Decision?
Filing a second application for disability
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