Is a Social Security Disability denial based more on your medical or work history?

Denials on Social Security Disability and SSI disability claims are based on both an individual's medical history and work history as well.

A claimant's medical records will allow a disability examiner (examiners are the individuals who make decisions on disability claims for the social security administration at an agency known as DDS, or disability determination services) to establish the following facts:

A) A diagnosis, thus an origin, of a condition.

B) A history of corroborative evidence, such as bloodwork, imaging scans (xrays, CT scans, MRIs, ultrasound, etc), physical examination, and special testing.

C) A history of response to treatment, including the claimant's response to prescribed medication.

D) A prognosis of the condition (i.e. where is it all leading to)

and hopefully,

E) Indications in the treatment notes regarding the claimant's physical and/or mental limitations so that these limitations can be used to rate the RFC, or residual functional capacity, of the claimant (for the purpose of evaluating the disability claim).

The claimant's work history will allow a disability examiner to determine what a claimant's job skills are and what the demands (both physical and mental) of their past work was. It will also allow the examiner to determine, based on the claimant's age and rated limitations (again, both physical and mental), what other types of work they might be capable of performing if their condition does not allow them to return to one of their former jobs (from within the past 15 years, which the social security administration refers to as the "relevant period").

How exactly is a medical vocational allowance granted? In short, this type of approval occurs when the disability examiner (or an administrative law judge if the claim is at the hearing level) has evaluated all of the medical records that have been gathered from all the doctors, clinics, and hospitals that have provided treatment to the claimant.

Using these records, the examiner will gauge what the claimant' residual functional capacity is (the RFC, in simplest terms, is what a person is still capable of doing despite their illness) and then compare the claimant's limitations to what was required of them in their various former jobs.

If the claimant is judged to be incapable of going back to one of their former jobs, the examiner will then consider whether or not their skills and training would allow them to do some type of other work, given the physical or mental limitations that they possess. If the examiner concludes that they cannot switch to some type of other work, they will be
awarded 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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