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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What makes you eligible for Social Security Disability or SSI?
The decision on your disability case--either a disability award or a denial of your claim--will be made on the basis of three types of evidence:
1. Medical evidence - This includes all the records that are obtained by the social security administration from your treatment providers, including admission and discharge summaries, reports of bloodwork, imaging (CT scans, xrays, PET scans, and MRI scans), and the notes made by your specific doctors, particularly the doctor who would be considered your treating physician. If your claim is based on a mental disorder, of course, your psychiatrist would be considered your treating physician.
Medical evidence, at the disability application and reconsideration appeal levels, is generally confined to just medical records. However, at the social security hearing level, it usually includes (assuming the claimant's disability attorney or disability representative is competent and experienced) a statement from the treating physician on something known as an residual functional capacity form or medical source statement.
2. Work history or Academic performance information - For adults who are attempting to qualify for disability, the second area of information that will come under consideration will be related to their work history. What this essentially means is that a disability examiner will review the claimant's relevant work history (jobs worked in the prior fifteen years) and try to determine if the claimant has the ability to go back to one of those jobs, or perform some type of other work based on their various skills and training.
For children whose parents are filing for SSI disability for them, work history, obviously, is not an issue. But the child's ability to engage in age-appropriate activities is. And, therefore, social security will evaluate how the child is performing in school. This will mean that a disability examiner will try to obtain school records, reports of academic achievement testing and IQ testing, and sometimes questionaires completed by the child's teachers.
3. Information about the claimant's ADLs, or activities of daily living - Normal daily activities are considered by SSA (the social security administration) to provide insight into whether or not a person can engage in work activity (or, for children, age-appropriate activities).
For example, if a person has degenerative disc disease, it would be normal to expect that they might have difficulty remaining in one type of standing or sitting position for very long, or difficult bending or crouching, or lifting objects above a certain weight. If their prior employment required them to engage in these types of physical activities, they may no longer have the ability to return to that type of job, or do any other type of job that utilizes such activities.
The question becomes, how will the social security administration know if an individual has a certain type of limitation, or set of limitations? Simply being diagnosed with a certain impairment is generally not proof, in and of itself. And while medical records provide the bulk of the evidence used on a case, very often the records recorded by physicians do not make mention of specific physical limitations or mental limitations.
For this reason, then, disability examiners will usually contact a claimant and ask them about their normal daily activities. They may do this by sending out a questionaire for the claimant to complete and return, or they may call the claimant directly. They may also (and often do) contact an individual who knows the claimant-called a third-party contact person-and this person is usually supplied at the time the claimant files for disability.
Continued at: Part II: What makes a person eligible to receive disability benefits?
Return to: Social Security Disability Resource Center, or read answers to Questions
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