The Disability Decision Process and What gets taken into Consideration

    What Happens When You File a Social Security Disability Application?
    You should be able to provide the claims representative with your medical treatment sources and make sure the information is complete and detailed. Keep in mind that this information will be used by a disability examiner to request your medical evidence and that if you fail to include a particular treatment source, or provide incompete information, it could significantly delay your case.

    What does social security mean by disability, i.e. what is the definition?
    The definition of disability used by the Social Security Administration is different from what many applicants and potential applicants might expect.

    Who qualifies for disability? - Qualifying is based on evidence of functional limitations
    Though there is a list of medical impairments with detailed approval criteria, the majority of claims are not approved in this manner (listing-level requirements tends to be very specific and, in most cases, a person's medical evidence will not contain this level of detail).

    The Levels Of The Social Security Disability and SSI Application and Appeal Process
    If your initial disability claim is denied, you file a request for reconsideration appeal. This appeal basically involves the completion of a disability report form (form SSA 3441).

    Does social security have a rigorous disability criteria evaluation process?
    The Social Security Disability and SSI evaluation process is fairly rigorous in a variety of ways. First, there's the sheer amount of time that a claim can take.

    Who Makes the Decision at the Social Security Disability, SSI Hearing Level?
    The ALJ uses essentially the same process to decide a claim as a disability examiner when you first apply for disability benefits.

    What tools are used by a Social Security Disability Examiner to Make a Claim Decision?
    The medical records will be used to interpret what the claimant's RFC, or residual functional capacity is. This is a measurement of what a person can still do despite their condition.

    You Must Give Social Security Disability Your Work History When You Apply
    Although Social Security has access to your work history as far as where you have worked and how much you have earned, if you are applying for disability you must supply them with a bit more information for the purpose of evaluating the vocational aspects of your claim.

    What does social security mean by past work?
    Past work potentially includes all the jobs that you might have done in the past fifteen years. This fifteen year period is known as the relevant period.

    How does Social Security Disability get Information about your past work?
    In nearly all cases, the disability examiner who processes the claim will rely entirely on the information provided by the claimant at the time of filing the disability application. This includes job titles, dates worked, and the duties of each job.

    What does social security mean by other work?
    What is other work as far as Social Security Disability and SSI are concerned? This is actually where the social security administration's disability evaluation process becomes more hazy. Other work can include many types of jobs that a claimant has never worked, and which might not even exist where a claimant lives.

    What Does It Mean If you Are Denied For Disability Because You can do Other Work?
    Step five is the final step of the sequential evaluation process and it involves a determination as to whether or not you are able to perform other types of work.

    The Social Security Disability Decision and Your Ability to Work
    To be eligible for Social Security Disability benefits, a claimant must be both unable to perform any jobs held in the past 15 years, and unable to perform any other job based on claimant's age, education and limitations, due to the stated medical condition.

    How does Social Security Disability Decide if you can Work or Not?
    On the RFC form, the examiner will indicate the claimant's lifting capacity, their ability to stand during a normal workday (8 hours), their postural limitations (how well can they balance, crawl, stoop, climb, balance, etc), as well as a number of other physical capabilities.

    What happens in the processing of a disability claim after you file?
    Many people think that the claims representative who completed their disability interview and did the intake work for their application is responsible for making the medical determination on their disability claim, but that is not the case. Once your disability interview is completed, your file is sent to a state disability agency for a medical determination and processing.

    What is DDS, or disability determination services?
    After the claim is sent to DDS, it is assigned to a disability examiner who functions similarly to an insurance claims manager. The disability examiner is a specialist who has been trained to interpret medical records and vocational data (involving jobs and work histories).

    Who will decide my Social Security Disability claim?
    The job of the disability examiner is to gather your medical evidence and review it, looking for evidence of functional limitations that you might have, either mental or physical or both. The examiner does not perform this task strictly on his own, however. The examiner is actually assigned to a case processing team. And this team includes a unit medical consultant, who is a medical doctor.

    After you file for SSD, the Disability Examiner may contact you for additional information
    If the examiner determines that there is not enough information for them to make a determination, they will contact you to schedule an examination. Your disability examiner will most also likely contact you so you may provide them with information about how your disabling condition affects the performance of routine activities such as household chores, grocery shopping, socializing, grooming, etc.

    Social Security Disability, Medical Records, and a Person's Limitations
    Notations in the medical records as to a person's limitations can allow a disability examiner or judge to get an overall idea of an individual's degree of limitations. It can also allow the decison-maker on a disability claim to determine if the claimant can return to their past work.

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.