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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

Social Security carefully reviews your medical records for evidence of disability



 
"What does Social Security look for in your medical records?" This, surprisingly, is a question I don't hear very often. However, I remain convinced that the great majority of individuals filing for disability benefits has wondered at some during an application or appeal just what it is that social security looks for when evaluating their medical records. In other words, how do you get approved?

Related:

1. How far back will Social Security look at your medical records?
2. The best medical records for a disability claim
3. Medical records at disability hearings
4. Disability hearing decisions

Here's a basic answer to the question and it applies to all levels of the system, which, for most claimants, will be the disability application level, the request for reconsideration, and the disability hearing. It also applies to both types of adjudicators -- examiners who render disability determinations at the initial and reconsideration stages and ALJs (ALJ means administrative law judge) who decide the outcome of disability hearings.

In reviewing your medical records, the social security administration looks for evidence of a claimant's inability to earn at least a certain minimum level of income (known as SGA or substantial gainful activity) while engaging in the performance of either A) past work (potentially any job that has been done in the last 15 years) or B) other work (which can include a wide range of work, but which may be limited to certain types of work as determined by an individual's age, education, skills, and functional limitations).

If you're thinking to yourself, "I thought working made me ineligible for disability", you are incorrect. However, this is a common mistake made by many, simply because the social security definition of disability is a little complex. In actuality, the social security administration states that an individual is considered disabled and eligible to receive benefits if they cannot work and earn at least a certain amount (defined as SGA) for a period of at least a year.

How does this all translate for the individuals who work on Social Security Disability and SSI claims? Here's how:

A disability examiner who is assigned to a case reads the medical evidence that is associated with it and develops a synopsis or summary that allows the examiner to conceptualize what the claimant's physical and/or mental limitations are. This synopsis is used to develop an RFC form, or residual functional capacity form, which basically states what the claimant is incapable of doing.

This preliminary RFC and the examiner's writeup or synopsis are reviewed by the medical consultant (or psychiatrist, depending on the impairments in question) who is attached to the examiner's unit. Following this consultation, a final residual functional capacity determination will be made (in other words, the final RFC will be based on what the doctor agrees to) and the examiner will begin to examine the vocational aspects of the case.

How is this done? The examiner will review the claimant's work history and determine the functional requirements of the claimant's past work. If the claimant's current functional capacity assessment precludes the ability to engage in past work, then the examiner will proceed to the next step in the evaluation process.

The next step is to evaluate whether or not the claimant can perform some type of other work. Other work may include a wide range of jobs that the claimant has never performed but may be capable of performing based on the claimant's age, education, job skills, and current limitations (indicated by residual functional capacity assessment).

It goes without saying that "other work" is the step at which many claimants are denied their disability benefits. And at a hearing, of course, representation provided by an individual who is familiar with vocational factors (as well as how to engage in a discussion of work hypotheticals) can literally make the difference between winning or losing a case.

However, this discussion of the decision process utilized by examiners at the initial claim and reconsideration levels also highlights the importance of providing the social security administration with a complete and detailed description of one's work history.








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



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These pages provide answers to basic questions about pursuing disability benefits

How and why to check Social Security Disability Status
Social Security Disability back pay
Non medical requirements for disability
Qualifying for disability, SSD SSI
When does social security consider you eligible for disability benefits?
Who qualifies for SSI?
Forms to complete when filing, applying for disability
How long does SSDI and SSI disability take to get?
Filing for disability with Depression
Can You Get Approved For SSI or SSD Benefits with a Mental Condition
How long for a disability judge to make a decision?
While you are in your disability interview
The SSD and SSI definition of disability
Filing for disability with carpal tunnel syndrome
Social Security Disability SSI and Fibromyalgia
Can you work if you get a disability check?
Disability application denied
File for disability, the application
How to get disability benefits
Conditions that get approved for disability
How to Appeal a disability claim denial from Social Security








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.