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Social Security List of Conditions
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Medical Evidence and Disability
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SSD SSI Definitions
SSDRC authored by Tim Moore
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Proving the requirements for disability in North Carolina
Continued from: What are the disability qualifications in North Carolina?
The inevitable question, of course, is how do you prove that your functional limitations are great enough that you cannot perform work activity.
At the first two levels of the system, application and reconsideration appeal, claimants are not really given much of a chance to prove anything. The decision is made by a disability examiner and then sent to the claimant after it has been made. All in all, the process is fairly one-decided.
Having said this, when claimants have representation at the application or reconsideration stage, there may be an opportunity to analyze the evidence of the case and find that it is well supported for an approval. This will usually involve a disability representative contacting the disability examiner to provide either additional medical evidence, or an interpretation of the evidence that argues for approval.
And at the hearing level, of course, this is exactly the role of the disability representative, but even more so. When a case gets to the hearing level, where the decision will be made by federal judge, the Social Security Administration no longer gathers medical evidence for the case. Responsibility for obtaining medical record updates then falls completely to the claimant, or their representative.
This is important to note because, by the time a case gets to the hearing level, usually at least a year will have taken place between the time of the last denial and the hearing. This means that the records in the case file will be old, and from the standpoint of attempting to win benefits, will be relatively useless. Under Social Security guidelines, for a person to be approved for continuing monthly disability benefits, they must present at least some evidence that is not older than 90 days.
In addition to presenting recent evidence, however, there must be a presentation of evidence that explicitly makes clear that the claimant's functional limitations are great enough that they cannot be expected to return to work activity. As we have previously stated, most medical records fail to indicate specific functional limitations and are of limited value in proving the requirements for disability are met.
This is why a disability representative will typically attempt to obtain a medical source statement from one of the claimant's physicians. On this, the physician will be asked to indicate in specific ways how the claimant is limited. This will allow the decision-maker, the judge, to determine if the physician effectively supports the case.
Does the opinion of the claimants treating physician really matter? At a disability hearing, the opinion of a medical doctor who has a history of providing treatment to the claimant can actually be classified as "controlling weight "evidence. This basically means that the doctor's opinion can decide the outcome of the case, as long as the doctor's opinion is not contradicted by the doctor's own medical records.
Unfortunately, at the first two levels of the system, a statement from a doctor, even when it is objective and highly detailed, will often be ignored by disability examiner.
At NC DDS (North Carolina disability determination services), this is, sadly, often the case. Why? Because disability determination services in North Carolina has a built-in "culture of denial", and they do not necessarily follow the Social Security guidelines to the absolute letter.
Judges, though, at the various hearing offices in North Carolina tend to give full consideration to the opinions of treating physicians, as is prescribed by Social Security regulations.
At a hearing, a disability representative will typically present compelling medical evidence that usually includes a medical source statement from one of the claimant's own doctors.
However, they will also present a case that is supported by the appropriate regulations and rules of the system, all of which is necessary to prove the case and win the claimant their benefits.
Return to: Social Security Disability Resource Center, or read answers to Questions
Filing for NC disability benefits
Applying for Disability in North Carolina - How to apply, qualify, and meet filing requirements
Applying for NC disability benefits
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Basic questions about disability benefits in North Carolina
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Can You Work and Collect Social Security Disability in North Carolina?
How to Get the Status on Your Social Security Disability Claim in North Carolina
How do I get help to win my disability claim in North Carolina?
The disability process in North Carolina
What condition or conditions qualifies for disability in North Carolina?
How long does it take to get through the disability system in North Carolina?
Is it hard to get disability benefits in North Carolina?
What are my chances of being approved for disability benefits in North Carolina?
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Disability determination services in North Carolina
Disability decisions in North Carolina
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How does the North Carolina Social Security disability determination process work?
Getting disability benefits in North Carolina
Getting denied for disability in North Carolina and filing appeals
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How to get on disability in North Carolina
NC Disability requirements and qualifications
Will I Qualify For Disability Benefits in North Carolina?
What is the criteria for disability benefits in North Carolina?
What are the disability qualifications in North Carolina?
Proving the requirements for disability in North Carolina
How do you meet the Disability qualifications in North Carolina?
SSI and Social Security Disability requirements in North Carolina
How do I Know If I Qualify For Disability in North Carolina?
Winning Disability benefits in NC
How do I win disability benefits in North Carolina?
Improving your chances of getting disability in North Carolina
How to improve the chances of winning a North Carolina disability hearing
Will an attorney or representative help me win North Carolina disability benefits?
Winning disability benefits in North Carolina
Mental Disability benefits in NC
Receiving disability for a mental condition in North Carolina
How do you receive benefits for a mental disability in North Carolina?
Getting approved for mental disability benefits in North Carolina
Disability awards and award notices in North Carolina
Getting a Social Security disability award in North Carolina
The Social Security disability award notice process in North Carolina
What affects how much time it takes to get a disability award in North Carolina?
Disability representation in North Carolina
Should I get a disability representative or lawyer in North Carolina?
Who can provide disability representation in North Carolina?
Hiring a Qualified Disability Lawyer in North Carolina
How do Disability Lawyers in North Carolina get paid their fees?
Denied for disability in North Carolina, should I get an attorney or representative?
Disability attorney fees in NC - paying your lawyer or representative
How does a disability lawyer or representative get paid in North Carolina?
How much does the fee cost for a disability attorney in North Carolina?
Do you pay your disability lawyer in North Carolina or does Social Security pay the fee?
Will your North Carolina disability lawyer charge you upfront for taking your case?
Will your NC disability attorney charge you for any expenses other than the main fee?
NC disability hearings
What kind of decision will you get at a disability hearing in North Carolina?
NC disability hearing - how long for a decision?
Do you have to go to a Social Security hearing in North Carolina to get approved for disability?
The disability hearing in North Carolina- things to keep in mind
How do you prepare for a disability hearing in North Carolina?