SSDRC

Filing an Application for Disability Benefits

Social Security Disability List of Impairments

Social Security Disability and SSI Back pay

Social Security Disability Status

SSI Disability Benefits

Social Security Disability and SSI Requirements

Social Security, SSI, and Mental Disability

How Long Does It Take To Get Disability Benefits?

Qualifying: What do you Need to Prove to Qualify for Disability?

The Social Security Disability Approval Process and the Criteria for Decisions

What follows is a short description of the disability approval process, which will hopefully help claimants or even potential claimants understand the process by which social security disability claims are approved.

1. After an application for disability benefits is made to social security, the case is transferred to the state agency responsible for making disability determinations. There, it is assigned to a disability examiner who will evaluate the claim.

2. The disability examiner sends requests for medical records to all physicians and medical facilities listed by the claimant on the disability application. After receiving them, the disability examiner will evaluate the records; however, it is important to note that it could take months to receive the requested records back from doctors, hospitals, or other medical professionals.

3. The examiner may refer to the social security impairment listing manual (known as the blue book and published by the social security administration under the title "Disability Evaluation under Social Security") to evaluate the claimant’s physical or mental condition. Impairments listed in the manual have strict disability criteria, and even being diagnosed with a listed condition will not necessarily result in approval if the medical records do not support the requirements of the listing.

4. In the majority of cases, a claimant will not be approved on the basis of meeting, or equaling, a "listing" in the manual (such as for depression, a specific form of cancer, or a condition of the spine). If it becomes obvious to the disability examiner that the obtained medical records do not support an approval on the basis of a listing, then the examiner will employ an evaluation method known as "sequential evaluation". Using this method will require that the disability examiner do the following:

A. The examiner will determine what the claimant's residual functional capacity is. RFC, or residual functional capacity is simply an assessment of what a person is still capable of doing. If the claimant has one or more physical impairments, then the examiner will determine a physical RFC. If the claimant has one or more mental impairments, then the examiner will determine a mental RFC. In many cases, of course, the examiner will determine both a physical and a mental RFC. Will the examiner do this with or without the input of medical and psychological consultants? In most cases, the examiner will be required to consult with either a physician or a psychologist who is part of his or her claim processing unit before the final RFC determination (or determinations) can be made.

B. After the claimant's residual functional capacity has been determined, the disability examiner will compare this rating (or ratings) to the requirements of the claimant's prior jobs. This will be done to determine if the claimant has the ability to go back to one of their former jobs. If it is decided that the claimant cannot go back to one of their former jobs, the examiner will investigate the possibility of the claimant switching to some type of other work (that the claimant has never done before). This will be based on the claimant's work skills, as well as their age, education, and residual functional capacity.

C. If it is determined that the claimant cannot do their past work, or do some type of other work, they will be approved for disability. If the claimant can do either their past work (any job they have held for an appreciable period of time in the last fifteen years) or some type of other work, then they will be denied on their claim for disability benefits.