How does Social Security Disability Decide if you can Work or Not?

How to prove you are disabled
and win disability benefits

An SSDI (social security disability insurance) or SSI disability claim will be determined on the basis of what an applicant's medical records have to say about their condition.

The records are requested by a disability examiner so that the examiner can determine the following: A) what physical or mental limitations, or restrictions, the individual possesses and B) whether or not those limitations make it impossible for the individual to engage in normal activities of daily living, specifically the ability to work and earn a substantial and gainful income.

This is, of course, a simplified statement of what occurs on a disability case. For example, in addition to gathering the needed medical evidence, the disability examiner will be required to rate the claimant's restrictions on a form and have the rating agreed to by other specialists in the disability examiner's unit.

In the case of a physical condition, the examiner will fill out something known as an RFC form. RFC stands for "residual functional capacity" and it literally translates to "what a person is still capable of doing".

On the RFC form, the examiner will indicate the claimant's lifting capacity, their ability to stand during a normal workday (8 hours), their postural limitations (how well can they balance, crawl, stoop, climb, balance, etc), as well as a number of other physical capabilities.

In the case of one or more mental impairments, the disability examiner will complete an MRFC, or mental residual functional capacity form, which will likewise attempt to rate the claimant's remaining mental functionality.

In either case, the disability examiner will have a consultant within their case processing unit essentially sign-off on the examiner's ratings of the claimant (assuming, of course, that they agree with the examiner's assessment; the consultants are, obviously, part of the examiner's unit to provide some level of oversight and to provide guidance to the disability examiner who is not a medical professional).

For a physical RFC rating, this will be done by a M.D. physician and for a mental RFC rating, this will be done by a Ph.D.-level psychologist, or another M.D. who has practiced as a psychiatrist.

As previously stated, the ratings that are given to a disability claimant are based on the information contained in their medical records. How does social security use this information to decide whether or not a claimant can work? By comparing the claimant's current physical and mental limitations to whatever was required of them in their past jobs.

Social Security Disability Decisions and SSI disability decisions are both medical and vocational in nature. This means that information regarding the claimant's history of employment is used to help determine the claim, as well as the information contained in their history of medical treatment.

Continued at: Social Security Disability, SSI, and Whether or Not a Person can Still Work

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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