Overview of Disability

Disability Back Pay

Disability Requirements

Disability Applications

Disability Advice Tips

How long do cases take?

How to win Disability

SSD Mistakes to avoid

Disability for Mental

What if you get denied?

How to file Appeals

Disability through SSA

SSI Disability Benefits

Disability for Children

How do I qualify for it?

Working and Disability

Disability Award Notice

Disability Lawyer Q&A

Disability Conditions List

What is a disability?

Your Medical Evidence

Filing for your Disability

Disability Eligibility

SSD SSI Definitions

Recent Questions

SSDRC Disability Blog

How Will Social Security Decide a Disability Case that's filed?

All Social Security Disability (SSD) and Supplemental Security Income (SSI) cases are decided based on the medical evidence supplied, either by the claimant or the claimant’s legal representative, to the social security administration.

It can’t be stressed enough, really, how important it is for a claimant to take the time to put together a medical history that supplies all of the medical facilities at which he or she has received treatment, including names of treating physicians, addresses, and accurate phone numbers.

This may take some extra time and calling around before filing the initial claim, but putting down that you received treatment “at the cardiac treatment center on the west side” is not really all that helpful to a disability examiner when it comes to tracking down your records.

To reiterate: If you don’t provide accurate contact information to the examiner, you will delay your case for weeks, even months, or your treatment records may not be located at all, which could mean the difference between being awarded disability or being turned down altogether.

What types of medical evidence can help you win disability benefits? The answer to this question is, potentially anything and everything. Doctor’s notes, records of being admitted and discharged from hospitals and emergency rooms, and above all, any detailed statements from your treating physician that supply information as to your residual functional capacity (the actions you are able to perform despite your medical condition), will help a disability examiner or judge evaluate your claim.

This goes as well for any disability claims made on the basis of mental conditions as well—any psychiatric records, admittance and discharge from medical facilities, evaluations, and treatment summaries provided by your psychiatrist are very important to your case.

How does a disability examiner (an employee of the state disability determination services agency who makes SSD/SSI decisions for the federal social security administration) use medical evidence to evaluate a claim? The examiner will look over all of the medical records and make notes on any medical diagnoses, lab reports, x-rays, CT scans, spirometry (pulmonary functioning) tests, etc., and decide if the records support the claim of an impairment, and if that impairment meets the criteria of a listing in the blue book (a manual that lists medical conditions that the social security administration deems potentially disabling).

If the examiner determines that the claimant has a condition that is not listed in the blue book, or has a condition in the blue book but does not present with all of the symptoms required to be approved for that listing (it’s hard to meet all of the criteria necessary to qualify for a listing as they are very specific), then the examiner will decide if a medical vocational allowance should be granted to the claimant.

The medical vocational allowance, or Med-voc, is awarded to those with documented medical conditions that, although not specifically listed in the blue book, still prevent an individual from engaging in substantial gainful activity (SGA). SGA equates to a monthly gross income limit on how much a person can earn and still be eligible to receive, or apply, for disability benefits. So if your condition prevents you from earning more than that, you may qualify for a medical vocational allowance, i.e. a disability approval.

To see the current limit: SGA earnings limit.

Medical vocational allowances often hinge on statements from a treating physician regarding a patient’s residual functional capacity as well as the physician’s opinion about your chances of recovery in the future, or the likely progression of your illness.

If your physician backs up the claim that you cannot perform your current job, then the disability examiner, before awarding a medical vocational allowance, will try to determine if you could perform some past work, or other type of work. The examiner will use a vocational grid to make this determination, which is designed to ensure that examiners in all states take into consideration a claimant’s job skills, past work, education and age before suggesting other employment to which he or she may be suited.

When it comes to disability claims that are awarded on the basis of medical vocational allowances, a complete work history can be as important as complete medical history. Again, do not cut corners when you supply your work history with your initial application. List not only past jobs and any titles you have held, but also your specific duties, so that there is no guesswork on the part of the examiner as to what you are or are not capable of doing. Also, list good contact information for your past supervisors so that they can confirm your employment and the capacity in which you acted while in your position.

If at any point in the process you have new information that is relative to your case, be it new test results, medication, treatments, or diagnosis, be sure to supply it to your social security office immediately so that a disability examiner will consider it when deciding your case.

Return to:  Social Security Disability Resource Center, or read answers to Questions

Information on the following topics can be found here: Social Security Disability Questions and in these subsections:

Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI

These pages answer some of the most basic questions for individuals who are considering filing a claim.

Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
How to Apply for Disability - What medical conditions can you apply and qualify for?
Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
What happens if I file a disability application and it is denied by a disability examiner or Judge?
How to Prove you are disabled and qualify to win disability benefits
How do you prove your disability case if you have a mental condition or impairment?
Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria