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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The Medical Requirements for Receiving Social Security Disability or SSI
Medical Eligibility Requirements for both Social Security Disability and SSI
To receive either SSD or SSI disability benefits, you must obviously be able to prove that your mental or physical condition is disabling. You prove this by the information contained in your medical records and potentially also by statements submitted by the physicians who have treated you.
Note: the social security administration does not attempt to obtain medical source statements, also known as RFC, or residual functional capacity, statements from a claimant's treating physicians. However, if you go to a disability hearing before an administrative law judge and you are represented by a disability lawyer, there is a good chance that your lawyer will attempt to get such a statement to add to your case since it can often make the difference between winning or losing a claim at a hearing).
What does the social security administration mean by "disabling"?
Social security does not take the viewpoint that your condition must render you completely unable to function. It does take the position, though, that your condition must be severe enough that it prevents you from able to work at any job and earn the income limit for SGA, or substantial gainful activity, for a given year. This includes working at jobs you have held in the past, and other jobs that the social security administration may consider you capable of performing based on your medical and vocational profile.
Obviously, then, winning a claim for social security disability or SSI will boil down to specific eligibility requirements, namely proving that you have certain physical and mental limitations that make it impossible for you to engage in work activity while earning SGA-level income.
Proving such limitations is based entirely on extrapolating from the information contained in your medical records, which can be a difficult task considering that most medical records and mental health records make little reference to how the condition actually affects one's ability to engage in and perform normal daily activities.
Winning a disability claim also means properly identifying a claimant's prior jobs and accumulated work skills so that it can be demonstrated that the claimant's functional limitations are not up to the task of going back to a former job or performing some type of other work for which those skills could come into play.
In either case (medical factors or vocational factors), the entire evaluation of a disability claim is largely beyond a claimant's control at the initial claim, or disability application, level. The same is true of the first appeal level, the request for reconsideration. This is because at both levels, the claim is decided by a disability examiner and neither the claimant nor the claimant's disability representative (who can be an attorney or a non-attorney) is significantly involved.
At the disability hearing level, however, the claimant, and the claimant's disability attorney if he or she has one, assume a much greater role. This is because, unlike the prior levels, the claimant will meet the decision-maker (an administrative law judge) at the hearing.
Also, the social security administration no longer gathers medical records on the claimant's behalf once the case moves beyond the first appeal, the request for reconsideration. So, at a hearing, whatever new records are presented, or whatever physician statements are presented, these will have been obtained and submitted by the claimant and/or their disability attorney.
Return to: Social Security Disability Resource Center, or read answers to Questions
Who qualifies for disability? - Qualifying is based on evidence of functional limitations
The Social Security Disability Approval Process and the Criteria for Decisions
How does Social Security Disability decide that you cannot work?
How do you Win Benefits under Social Security Disability or SSI?
Medical Disability Requirements for SSD and SSI
The non-medical Disability Requirements for SSD and SSI
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