How Social Security looks at your past work when deciding your disability claim
Past Work. If you read this site, you'll come across this phrase time and time again. The phrase itself would seem fairly obvious in and of itself. Just the same, though, it should be defined in the context of an application for Social Security Disability or an application for SSI. Or, for that matter, an appeal of any kind. The truth is, work is an issue that is inextricably linked to the disability benefit evaluation process. "Work" can, just as much as medical records, determine whether or not an individual will be approved for or denied disability.
So, what is past work in the eyes of the social security administration and those who serve as decision-makers on claims (administrative law "disability" judges and state-level disability examiners)?
Past work may potentially include any job you have done...in the last fifteen years. This fifteen year period actually has a name and is known as the relevant period. Why does the relevant period exist? Transferability of skills is probably the best rationale. Skills that were learned on jobs performed more than fifteen years prior are considered too far back in the past to be relied on for present and future employment.
That's a basic definition of past work. How does a claimant's past work affect an application for disability? It really has to do with the social security definition of disability and how SSD and SSI cases are processed.
In a nutshell, it works like this:
1. A claimant completes an application for disability at a social security office.
2. The person who took the application, a Claims Rep, or CR, sends the applicant's file to an agency within the state whose responsibility it is to medically process the claim and make either a disability approval or denial. In most states, this agency is known as DDS, or disability determination services.
3. At the state agency, the file is assigned to a disability examiner, an individual who will actually render the decision on the case.
4. The disability examiner will gather the claimant's medical records and will attempt to make a decision in one of two ways. First, the examiner will attempt to see if the claimant will be eligible for disability benefits on the basis of meeting or equaling a listing. Listings are basically the disability approval criteria for conditions that are contained within the Social Security Disability list of impairments (this is often referred to as the blue book).
However, not all conditions are included in the listing book and not every claimant who is eventually approved for benefits will be awarded on the basis of meeting a listing. For those who do not meet or equal a listing, or have a condition that is not contained in the listing book, the disability examiner will attempt to render a decision by using something known as sequential evaluation.
What is sequential evaluation? This is where "past work" becomes relevant to an SSD or SSI claim for benefits. For an applicant to be approved, they must have a severe condition that lasts (or can be projected to last) for one full year and which prevents them from working and earning an amount that is equivalent to what is known as SGA or substantial gainful activity.
The last paragraph contained the word "working". What does social security mean by "working"? SSA considers work to fall into two separate categories. The second category is known as other work. The first category, of course, is past work.
If a claimant is judged to be unable to return to their past work (remember, past work is potentially any job performed within the last 15 years) as a result of the physical or mental limitations imposed by their condition (or conditions), then they may possibly be awarded disability benefits. I say "possibly" because in order to be approved in this manner (i.e. not meeting or equaling a listing in the blue book), a claimant who is judged unable to return to their past work must also show that they are incapable of performing some type of other work.
How does a disability examiner (or a disability judge at a hearing) make the decision as to whether or not a claimant can return to their past work, or be judged to be incapable of doing this?
Here's how. The examiner will look at all the jobs listed by the claimant at the time of application. The examiner will then categorize these jobs by referring to a special (many would say outdated) manual that attempts to classify all known jobs.
This manual will provide a skill level and functional capacity rating for all the jobs listed within it.
So, for the sake of simplification, let's pretend that a claimant only worked one job in the last fifteen years and this job was "tractor-trailer-truck driver". This particular job is classified as a medium exertion job. How does the classification of this job play into the processing of an SSD or SSI disability claim?
Here's a basic example. If the claimant's medical records are evaluated and it is determined that the claimant is now only capable of doing light exertion work, then the claimant (whose past work consisted of being a tractor-trailer-truck driver, a medium exertion job) will be considered to be unable to return to past work.
Of course, this is a fairly simple example, simple because it does not take into account any other jobs the claimant might have had, the skill levels of those jobs, and the claimant's age, and education. However, it does illustrate one basic fact about applying for disability, which is this: when you file for disability, just as important as it is to supply extensive information about your medical treatment, it is equally important to supply detailed information about your work history. Because the information you supply to social security will have a direct bearing on the outcome of your case.
Many claimants, in fact, would be surprised that disability decision-makers (examiners and judges) don't really have some "magic" way of learning about a claimant's medical sources or prior jobs. Instead, they primarily rely on information that is supplied by the claimant. And the more accurate and detailed that information is, the better the chances of winning benefits might be.
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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