Qualifying for Disability - What is Social Security Looking for?

Continued from: How to Qualify for Disability

Qualifying for disability is based on a decision that is both vocational and medical in nature and this is because the primary consideration is whether or not a person still has the ability to work and earn a substantial and gainful income. Your work history will be supplied by you and this should be detailed and clear. Your medical records, however, may not be so clear simply because the information that the social security administration is looking for is often not contained in your medical records.

What is social security looking for in medical record documentation? Evidence of limitations. For example, if you have a back condition, you may have difficulty with bending or crouching, or standing or sitting for prolonged periods. You may also have difficulty picking up objects over a certain weight. You may further have difficulty with normal daily activities such as carrying groceries or operating a lawn mower or a vacuum cleaner. These types of limitations are reasonably expected when a person has disc herniation, spinal arthritis, or degenerative disc disease.

However, SSA (the social security administration) will not presume that a person has certain limitations simply because they have a certain condition. Ideally, the claimant's limitations should be notated in the medical records obtained from a claimant's doctor, or doctors. Unfortunately, most doctors do not include this type of information in their notes. It is simply not what they consider to be part of their normal documentation.

That said, clear evidence of limitations is exactly what SSA needs in order to approve a disability claim. Without evidence of physical and mental limitations being clearly indicated in the available medical records, the disability examiner or administrative law judge will have no choice but to extrapolate, i.e. make their best determination. It should go without saying that this is often to the disadvantage of the claimant.

How can this deficiency be overcome? This is often accomplished by obtaining a statement from the claimant's physician, psychologist, or psychiatrist (depending on the nature of the impairment).

The following page discusses the type of statement that is typically obtained for a disability hearing. This statement is usually referred to as a medical source statement or residual functional capacity form.

Such a form, completed by a physician who has a history of providing treatment to a claimant (and is therefore qualified to speak with regard to the claimant's prognosis and current limitations), may be submitted to the social security administration at earlier steps of the process; however, disability examiners very often do not accord much weight to the opinion of a treating physician, while administrative law judges will generally give proper consideration to such statements as long as they are also supported by the remainder of the medical record.

Disability Lawyers, Medical Records, and Social Security Hearings.