How does SSA decide you get disability?

The role of the "medical vocational allowance" - Probably the easiest way to define the concept, and illustrate its importance, is to describe how disability decisions get made.

Here's a short, bulleted description of the disability approval process. This description is simplified, but it should provide an understanding of what a medical vocational allowance is.

1. An individual applies for disability at a social security office.

2. The case is transferred by the social security office to a state-level agency that makes decisions on disability claims for the social security administration.

3. At this state agency, the case is assigned to a disability examiner.

4. Generally on the same day that the disability examiner receives the case, he or she sends medical record request letters out to all the various doctors, hospitals, and clinics listed by the claimant at the time of application.

5. After the medical records have been received by the examiner (this may take weeks or months), the examiner will read and evaluate them.

6. The examiner will consider whether or not the claimant has a physical or mental condition that satisfies the requirements of a listing. What is a listing? A listing is any medical or mental condition that appears in the social security impairment listing manual. Impairments that are listed in this manual are given very specific disability criteria for the purpose of approving a claim. Not every condition, however, is contained in the listing manual and even if a claimant has a listed impairment, their medical records may not meet the requirements as set forth in the manual, which can be fairly strict.

7. If a claimant's condition, or various medical conditions do not the requirements of a listing, then the disability examiner will decide what the claimant's functional limitations are (based on reading the medical records) and will record this assessment on a residual functional capacity form. The form will basically indicate what the claimant can still do and what the claimant is incapable of doing physically or mentally (separates forms are used to record mental and physical RFC assessments).

8. If the claimant's residual functional capacity is so restrictive that it makes it impossible for the claimant to do their past and also makes it impossible for the claimant to do suitable other types of work, then the claimant will be approved for disability benefits in either the Social Security Disability or SSI disability program.

9. This type of disability approval, in which a claimant's functional limitations and capacity are compared to A. the work they have performed in the past and B. other types of work they might possibly do based on age, education, and job skills, is called a medical vocational allowance.

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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