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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

How are medical records and work history used to determine a Social Security Disability claim?



 
How are medical records and work history used to determine a Social Security Disability claim? This involves the step of the SSD application process in which the claim is handled by a disability examiner at an agency known as DDS, or disability determination services.

After a person A) contacts the social security administration (ideally, by calling or visiting a local social security office), B) has their disability inteview, and then C) has a disability application on file, the claim is sent to disability determination services (in some states, DDS may be known by other names such as the bureau of disability determination) where it is assigned to a disability examiner.

The disability examiner will focus initially on getting the medical records gathered. This occurs on day one of the examiner receiving the claim from the social security office where the intake was done. Using the information provided by the claimant at the time they filed their application for SSD or SSI, the examiner will start sending out letters to the various doctors and hospitals who have provided treatment to the claimant.



Getting the medical evidence gathered is what accounts for the largest portion of the waiting time. And the time required to get the records may amount to just a few weeks or several months. It is not uncommon for disability examiners to have to send multiple requests for records to the same facility, and make multiple follow up calls, and then fax previously mailed requests.

Once the medical records have been received, however, the disability examiner will review them, consult with a medical physician who is assigned to his or her case processing unit, and then determine what the claimant's residual functional capacity is.

The residual functional capacity, or RFC, is a measurement (some would say a guess) as to what the claimant is still capable of doing. For example, are they still capable of lifing 10 pounds frequently, or 50 pounds occasionally? Are they incapable of lifting more than this? Are they unable to sit for more than two hours at a time due to lower back pain? Are they unable to reach overhead, or grasp small objects? Are they unable to remember instructions? Are they unable to get up on ladders due to back issues, vertigo, or epilepsy.

These are the things addressed by a rating of a person's RFC. And bear this in mind that this is for a physical RFC; mental limitations are rated on an MRFC, or mental residual functional capacity, form.

After a disability examiner rates a claimant's RFC, they can then compare this rating to what the claimant did in their past work. Depending on what the claimant's past jobs required of them, and what their current capabilities are, they may be capable of going back to a former job (in which case they would be denied for disability), or unable to do this.

If a claimant is found to be unable to do a former job, then the disability examiner will examine whether or not it is feasible for the claimant to use their acquired skills and education to find some type of other work. When other work is considered, the examiner will also consider the claimant's education and their current level of physical and mental functioning (as rated on their mental and physical RFC assessments).

Medical records and the evidence they contain form the foundation for all decisions on disability claims. However, medical evidence is used in conjunction with the information about a claimant's history of work and the skills they have acquired in the course of their work history. This is only fair considering that individuals who had jobs requiring medium and heavy exertion will be less likely to do these jobs if they have physical limitations and also as they get older.

Additionally, individuals who have fewer transferrable skills will be less likely to find themselves in the position of being able to switch to some new form of employment.








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

Can you get temporary Social Security Disability or SSI benefits?

Permanent Social Security Disability

What is the difference between Social Security Disability and SSI?

Who is eligible for SSI disability?

Can I Be Eligible For SSI And Social Security Disability At The Same Time?

What makes a person eligible to receive disability benefits?

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?









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.