Being Determined Medically Disabled for Social Security Disability

Do not assume that because you have been diagnosed with a severe medical condition and received medical treatment for that condition you will be approved for Social Security Disability (SSD) or SSI benefits, even if you have a mountain of medical records to back up your claim.

Why? Because, unfortunately, so many physicians do not understand the kind of evidence that disability examiners (who make decisions for the state disability determination services agency) and federal disability judges (who hear appeals for disability claimants denied benefits by the state) are looking for when deciding disability claims.

It is not uncommon for a physician to treat a patient's symptoms for months, even years, without making any notations in his or her notes regarding the patient's real physical or mental limitations. And, without a definitive statement regarding actions that the claimant can no longer perform; such as sitting for long periods of time, typing, lifting, concentrating, focusing on a computer screen, etc., a disability examiner or judge will have no way of determining if you are able to return to your job or perform another type of work.

Disability benefits are meant to provide financial support to those who can't earn enough to get by. How much is enough? The Social Security Administration (SSA) sets a monthly amount, or standard living wage, known as the SGA (substantial gainful activity). You must be able to demonstrate that you cannot work in any job that would pay you more than that amount. And the only way to demonstrate that you cannot work is to have your physician provide details about the tasks that, because of your impairment, you are no longer able to perform.

Even if you have a signed statement from your physician stating that you are 100% disabled, or that you are unable to work, you will find your claim is likely to be turned down if the physician's opinion does not detail exactly how your medical condition limits your daily living activities.

So, if you are filing for SSD or SSI benefits, be sure to ask your physician to see a copy of your medical records so that you know exactly what's in there. If you find no or little mention of your physical or mental limitations, ask your physician to provide you with a residual functional capacity (RFC) statement, listing exactly what types of physical or mental tasks someone with your medical condition can reasonably be expected to perform. You might even want to pick up an RFC form from your local Social Security office and bring it directly to your doctor's office'it's really that important.

Remember, all disability decisions are based on medical documentation, and if your medical records do not supply the necessary proof that, not only are you disabled but that you can no longer work, they will do nothing to further your claim for disability.

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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