How will Social Security Determine if you get Disability Benefits?

When the social security administration assesses one's eligibility for disability benefits, it doesn't look so much at the condition, but, instead, at the functional limitations that are caused by the condition.

After those functional limitations (which can be mental or physical or both) are rated on something known as an RFC, or residual functional capacity, form, then the limitations are viewed against the requirements of whatever past work the claimant did. If the decision is made that the claimant cannot return to their past work, then the decision is made as to whether or not they can do some type of other work.

Again, the claimant's rated mental or physical limitations are used to make the decision. However, in the case of deciding whether or not a person can do other work, the social security administration will also consider various factors which will, logically, have an impact on a person's ability to switch off to new employment, such as how old they are, their level of education, and the level of their job skills, taking into consideration if those skills will transfer to other types of jobs.

The decision on a disability claim boils down to what a person can do--or can no longer do. Though we usually refer to the decisons issued by judges and examiners as medical decisions, this is really just half of the explanation because the decision is really medical and vocational in nature.

This is because the fundamental question is: Can the person still work? And the subsets to this are: Can they still do one of their old jobs? If not, can they can do some other job?

This is exactly why the condition you have is not the most important thing. It is really the effect the condition has on your ability to work. And this is measured by --

1. Reviewing your medical records to see how limited you are.

2. Reviewing your work history to see what you did in the past, and what skills you have.

The process is actually pretty plain, but what you need to do is make sure that SSA has access to all your medical records. Be sure to give them all your medical treatment sources. That includes your current ones and older ones. This is because SSA needs to determine if you are currently disabled, but they also need to determine how far back your disability goes so that they can determine how much disability back pay you may be eligible to receive.

Also, be sure to give them good descriptions of your past jobs, including job titles and explanations of what you did on the job. This is because SSA will try to identify your job and use the information in the federal database (currently the DOT, or dictionary of occupational titles) to understand what you did on your job. Obviously, this information will be used to see if you have the physical and mental capability of going back to your old employment, or have the skills to do something else.

Repeat: giving social security an accurate and detailed description of your past work is very important as it can help you get approved sooner versus later. In actuality, there are many many disability cases that drag on needlessly for many months simply because a claimant did not supply the information that could have helped a decision maker on a case approve the claim.

And, in reality, this is sometimes the chief benefit of having representation on a social security claim. A good representative will help ensure that the case is developed properly and that obvious mistakes are not made.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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