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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How does Social Security determine if I am disabled or not?
The social security administration will determine a claimant's eligiblity to receive disability benefits in one of two ways (and both apply equally to the social security disability or SSI disability program).
The First way - Satisfying the requirements of a listing
If a disability examiner or a disability judge (assuming the case is pending at the hearing level) examines the claimant's medical records and discovers fairly specific evidence regarding the claimant's condition or conditions, the examiner may potentially find that the claimant satisfies the approval criteria of a listed impairment.
What is a listed impairment? This is any mental or physical condition that is listed in the blue book. The blue book, sometimes referred to as the social security disability list of impairments, contains a wide variety of medical conditions, both physical and mental, as well as the criteria that must be found in the claimant's medical records in order for the claimant to be approved on the basis of a listing (such as the listing for ADHD, or the listing for Asthma, or the listing for lupus).
Being approved for disability benefits on the basis of "meeting a listing" or "equaling a listing" (by "equaling", the social security administration means having a comparable level of severity even if the very specific details of the listing are not met) can be difficult. Listings tend to have very specific requirements and the truth is that a claimant's medical records will very often not contain enough detail. Additionally, most medical conditions are not actually included in the listing book, such as carpal tunnel syndrome for example.
The Second way - Being approved for disability on the basis of a medical vocational allowance
Fortunately, for those whose medical records will not be detailed enough to meet or equal a listing in the blue book, there is a second way of being approved for either social security disability or SSI benefits. This way involves the five step sequential evaluation process used by the social security administration and it results in something known as a medical vocational allowance.
When a case is put through the sequential evaluation process (and this will happen unless it is fairly obvious that the claimant has a listing-level medical condition), the claimant's medical evidence will be used to determine how, and to what extent, they are functionally limited. The decision-maker, a disability examiner or a judge, will assess the severity of the claimant's conditions and then rate their functional limitations on either an RFC (residual functional capacity) form, or an MRFC (mental residual functional capacity) form. This rating will then be compared to the demands and requirements of the claimant's past work (social security will look at all relevant jobs within the past 15 years).
The goal, of course, is to see whether or not the claimant can go back to one of their past jobs. If the determination is made that they cannot return to a former job, the decision-maker will then attempt to determine whether or not the claimant can perform some type of other work. If this is also not possible, the claimant will be approved on the basis of a medical vocational allowance (which is referred to as such because the decision will involve both medical and work history information).
Return to: Social Security Disability Resource Center, or read answers to Questions
How Does A Social Security Disability Examiner Determine a Personís Functional Limitations?
How does Social Security determine if I am disabled or not?
How are medical records and work history used to determine a social security disability claim?
How will Social Security Determine if you get Disability Benefits?
What if Social Security Disability does not follow my doctor's assessment of my condition?
Can I get disability for arthritis in my shoulders, arms, and feet?
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