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 your disability claim?
How does social security decide your disability claim? Answer: medical evidence, medical evidence, medical evidence. Yes, it all comes down to...the medical evidence presented by you or your disability attorney.
Medical evidence, of course, takes many forms, ranging from the office notes provided by your personal doctor to the admission and discharge summaries provided by the hospitals you've been treated at. And, in the case of mental disability claims, they include the progress notes provided by a treating psychiatrist as well as any treatment summaries provided by a psychiatrist (which many psychiatrists will opt to supply, sometimes even in lieu of the actual treatment notes).
And, finally, medical evidence includes any detailed statements that you or your attorney are successful in obtaining from your treating physician. Such statements, particularly when they thoroughly describe and detail a disability applicant's remaining (or residual) functional capacity, can have a significant impact at a disability hearing held by an administrative law judge.
Social Security Disability Cases are denied on the basis of medical evidence and they are approved on the basis of medical evidence. And for this reason it is extraordinarily important for a disability applicant to list all medical sources on the disability report form at the time of application.
How does social security evaluate medical evidence in order to decide your disability claim? Here's a short answer and one that should give you a bit of insight into the daily functions of a disability examiner (if you don't already know this, disability examiners are the specialists who render determinations on Social Security Disability and SSI claims for the social security administration).
Examiners will review the medical records associated with a disability claim in one of two ways, either reading the records as they arrive in the mail, or waiting until all the records have been received and then reviewing them. Either way, though, the examiner will typically review the records, make notes from what is read, and look for the following:
1) Medical Diagnoses of specific physical and mental impairments.
2) Lab reports and values; for example, abnormal values that might be taken into consideration for liver disease and cirrhosis, kidney disease, and diabetes.
3. Imaging study reports, such as for xrays, CT scans, and MRI scans.
4. The results of specific testing, such as Pulmonary function tests (for respiratory impairments such as COPD and treadmill tests (for cardiac cases, such as those involving a heart attack).
5. Indications of a treating physician's assessment regarding a claimant's functional capacity.
6. Indications of a treating physician's assessment regarding a claimant's prognosis.
In reviewing the medical records, if the claimant appears to have significant documentation regarding a single impairment (such as asthma, epilepsy, bipolar disorder, depression, osteoarthritis, or stroke, just to use a few examples), the examiner will consider whether or not the claimant meets or equals the requirements of a listing.
What is a listing? A listing is any medical impairment, physical or mental, that is listed in the Social Security Impairment listing manual, usually referred to as the blue book. Impairments that are listed in the blue book are given very specific disability approval criteria. And, for the most part, this criteria is very difficult to qualify under.
If the disability examiner finds that the claimant in question either A) does not have a condition that is listed in the impairment listing manual or B) has a condition in the manual but cannot meet the approval criteria for that condition as set forth in the manual, then the examiner will evaluate the claim to see if a medical vocational allowance can be made.
In a medical vocational allowance, a claimant is approved for disability based on the determination that they cannot return to their past work, and cannot perform some type of other work. This type of disability determination is made with respect to a number of vocational factors that attempt to inject into the "disability evaluation process" certain real-world considerations regarding an individual's employability.
Consequently, consideration for a medical vocational allowance utilizes something referred to as the grid, a framework of rules that allow special consideration for a claimant's age, job skills, the particular jobs they have done in the past, and their level of educational attainment.
Because these factors play a role in the disability determination process, and because disability decisions are often based on vocational factors as well as medical factors, the following should be stressed.
1. Always supply detailed and correct information regarding medical treatment, both on a disability application and on a disability appeal. Also, if you have a claim that is currently being worked on and have seen a new doctor, have had some new testing, have experienced a change in your condition, or have a new diagnosis, let social security know immediately so this information can be taken into consideration.
2. Always supply detailed and correct information regarding your work history, including the titles of your past jobs, the dates employed, and the duties performed for each job. A failure to do this properly may potentially result in your past work being misclassified and may have an effect on your eventual disability determination.
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
How to get disability for depression
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
Social Security Disability SSI Exam tips
More Social Security Disability SSI Questions
Social Security Disability SSI definitions
What makes you eligible for Social Security Disability or SSI?
New and featured pages on SSDRC.com
Who can help me file for disability?
How Does Social Security Decide If You Are Disabled Or Not?
Vocational expert at a disability hearing
Who will decide my Social Security Disability claim?
How Does Social Security Decide How Much I Get For Social Security Disability or SSI?
Does Your Doctor Decide If You Get Disability Benefits
How does Social Security use Evidence to Decide an SSDI or SSI Disability Claim
How does SSA determine if a claim will be a denial or an approval?
Do you have to quit your job before filing for disability?
Can you qualify for Social Security Disability on the basis of fibromyalgia?
What are the requirements and criteria for Social Security Disability?
Can you get disability if you are younger age?
Disability at age 50 or older
Social Security Disability SSI and proving you can't work
How Residual Functional Capacity affects Social Security Disability and SSI claims
If I am waiting for a Disability Hearing, how often should I see my doctor?
Calling Social Security about a Disability Exam that was scheduled
How does social security decide your disability claim?
These pages provide answers to basic questions about pursuing disability benefits
How to file for disability, filing tips
What to Prove to Qualify for Disability Benefits
Applying for disability benefits, SSI and SSDI
What Disabilities Qualify for SSI and Social Security Disability?
Will you get disability back pay?
Social Security Disability And SSI Qualifications
Permanent Disability Qualifications for SSD and SSI
Social Security Disability SSI status
Disability lawyer representation, finding lawyers
Who will qualify for disability and what qualifying is based on
Qualifications for Disability Benefits
Important points about filing for disability
How long does it take to get disability after applying?
Am I Eligible For Social Security Disability?
Who is eligible for SSI disability?
How to get disability in Florida
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.