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How to file for disability, Filing for SSI
Disability Requirements, Disability Status
How long is the wait?, Disability Application
The Social Security List of Impairments
Qualifying for Disability, Mental Disability
Disability Lawyer Info, Disability Back Pay

How Does Social Security Decide If You Are Disabled Or Not?



 
Social Security uses medical records, work history, medical vocational rules, and a disability guidebook that contains a listing of impairments that affect the various body systems to decide if you are disabled or not.

Once you provide Social Security with your medical sources (names, addresses, treatment, medications and treatment dates) and work history (jobs you have performed in the past fifteen years that you worked at for three months or more, earned the substantial gainful activity amount or SGA, and had time to learn), your disability case is sent to a federally funded state disability agency for a decision. Once in the disability agency, your disability claim is assigned to a disability examiner who will make a decision as to whether or not you are disabled according to Social Security guidelines.

In order for the disability examiner to decide if you are disabled or not, they have to first gather medical records from the sources that you provided with your disability application. If they determine that you do not have enough current medical record information for them to make a medical disability decision, they will schedule you for a consultative examination with a doctor who is paid by Social Security to evaluate the current status of your physical and/or mental impairment.



You may be required to attend more than one consultative examination. This may occur, for example, because you have alleged both mental and physical disabling conditions but you have no current medical treatment (Social Security considers current medical treatment to be any treatment received within the past ninety days), or you have no medical records at all. Social Security rules require a disability examiner to have current medical information in order to make a decision.

While disability examiners like to have at least twelve months of medical history for their disability determination, it is not strictly required. From my experience as a disability examiner, a medical history that contains clear, concise medical treatment notes which address your treatment, prognosis, your response to prescribed treatment and the limitations caused by your condition or conditions usually help you to win your disability case. Conversely, consultative examinations alone rarely lead to an approval for disability benefits.

When the disability examiner has enough medical information to make their determination, they refer to the impairment listings contained in the Social Security Disability handbook, “Disability Evaluation Under Social Security". This is done to determine if your disabling condition meets or equals the severity requirement of the body system impairment listing that addresses your specific disabling condition or conditions.

For example, arthritis would be considered in the section of the listing book devoted to musculoskeletal impairments, while congestive heart failure would be considered in the section devoted to cardiovascular impairments.

If your disability condition is so severe that it meets or equals an impairment listing, you may be approved for disability benefits. If your specific limitations do not meet or equal the criteria of an impairment listing, you may still be approved for disability benefits provided that your disabling condition causes your residual functional capacity (what you are able to do in spite of the limitations of your disabling conditions) to be so restrictive as to prevent you from doing any of the jobs you have done in the past fifteen years, or any other kinds of work.

In other words, you may be approved for disability benefits through a sequential evaluation process that considers both medical and vocational factors.








Essential Questions

What is the Social Security Disability SSI list of impairments?

Can you work while getting or applying for Disability?

How Often Does Social Security Approve Disability The First Time You Apply?

Tips for getting Social Security Disability or SSI benefits approved

What medical conditions will get you approved for disability?

What kind of Mental Problems Qualify for Disability?

Receiving a Disability Award Letter

Conditions Social Security will recognize as a disability

Previously answered questions regarding SSD and SSI

Applying for disability in your state



Most popular topics on SSDRC.com

Social Security Disability SSI Questions

The listings, list of disabling impairments

Can a mental illness qualify you for disability?

Disability Lawyers prevent unnecessary denials

How much Social Security Disability SSI back pay?

How to apply for disability for a child or children

Filing a Social Security Disability SSI application

Filing for disability - when to file

How to apply for disability - where to apply

Qualifications for disability benefits

How to Prove you are disabled and Win your Disability Benefits

Qualifying for Disability - The Process

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Getting disability for fibromyalgia

SSI disability for children with ADHD

What is the Application Process for Social Security Disability and SSI?

Common Mistakes to avoid after being denied for Disability

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Related pages:

If Am Medically Disabled, Can Social Security Still Turn Me Down for Disability for Some Reason?
How will Social Security find you disabled?
When is a Person Considered Fully Disabled by Social Security?
Being Determined Medically Disabled for Social Security Disability
How Does Social Security Decide If You Are Disabled Or Not?
What makes you disabled for SSD, Social Security Disability Benefits, OR SSI?
How Disabled Must You be to get Social Security Disability Approved?
How Disabled Do You Have To Be To Collect Social Security Disability or SSI?
If I apply for disability and my doctor says I am disabled, is there a waiting period to receive benefits?
What does a child get if a person is approved for disability?
Getting a Disability Lawyer in California
Will I qualify for disability Benefits in California?
How long does it take to get disability in California?



These pages answer some of the most basic questions for individuals who are considering filing a claim.

Can you get temporary Social Security Disability or SSI benefits?

Permanent Social Security Disability

What is the difference between Social Security Disability and SSI?

Who is eligible for SSI disability?

Can I Be Eligible For SSI And Social Security Disability At The Same Time?

What makes a person eligible to receive disability benefits?

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?









For the sake of clarity, SSDRC.com is not the Social Security Administration, nor is it associated or affiliated with SSA. This site is a personal, private website that is published, edited, and maintained by former caseworker and former disability claims examiner, Tim Moore, who was interviewed by the New York Times on the topic of Social Security Disability and SSI benefits in an article entitled "The Disability Mess" and also by the Los Angeles Times on the subject of political attempts to weaken the Social Security Disability system.

The goal of the site is to provide information about how Social Security Disability and SSI work, the idea being that qualified information may help claimants pursue their claims and appeals, potentially avoiding time-consuming mistakes. If you find the information on this site helpful and believe it would be helpful to others, feel free to share links to its homepage or other pages on website resource pages, blogs, or social media. Copying of this material, however, is prohibited.

To learn more about the author, please visit the SSDRC.com homepage and view the "about this site" link near the bottom of the page.