What Happens During A Social Security Disability or SSI Application Interview?
Social Security allows applicants to file SSDI and SSI applications by phone, online, or using their local Social Security office. Regarding these options, the teleclaims center is generally not advised due to its long history of providing inaccurate information.
Secondly, attempting to file for disability online can be disadvantageous for one basic reason: The online process does not allow a claimant to speak directly with a Claims Representative, or CR--which may minimize confusion and mistakes made during the application or appeal process.
For the purposes of this question, we are addressing what happens during a phone or in-person disability interview that is conducted through a local Social Security office (related: What to bring to a disability interview).
Note: If an individual chooses to file their disability claim in-person, they should bring in a picture ID. If they are unable to do so, they will have to go through an identification process which involves the Claims Representative asking five personal questions:
In addition to a picture ID, you should bring your birth certificate with you (if you have it) and and you should be prepared to answer questions about the following topics:
1) Your medical conditions.
2) Your medical treatment sources (including the names, addresses, and phone numbers of doctors and clinics and hospitals, as well as treatment dates).
3) Your medications (those currently being taken).
4) Any testing that you have had.
5) Your work history.
These topics relate directly to how the Social Security Administration makes approvals on disability claims. The first method of approving a claim is by evaluating an individual's medical evidence to determine if they have a condition that is included in the Social Security Disability of impairments. Cases that satisfy the requirements of a listing may be approved on this basis.
These listings provide the approval criteria for a number of medical conditions, both physical and mental. However, not every medical condition is listed. And even if a claimant has a condition that is included in the listings, the approval criteria is usually very specific and difficult to meet.
For this reason, SSA provides a second method of being approved, known as a medical vocational allowance, which is how most approvals are made. In this type of decision, the claimant's medical records are reviewed to determine what their current level of functional capability is (for instance, they may be capable of doing sedentary work, light work, or medium work). This results in a rating known as an RFC, or residual functional capacity, rating.
The RFC rating is compared to the demands of the claimant's past jobs so that Social Security can determine two things:
1) Does the individual have the ability to go back to one of their past jobs? If the answer is no, a second question must be asked.
2) Given the individual's a) age, b) current level of functioning (their RFC), c) their work experience (their skills and the physical and mental demands of their past jobs) and d) their education, do they have the ability to switch to some type of other work?
This page adds additional information on this process: How does Social Security Disability Decide if you can Work or Not?
If the answer to both these questions is no, the individual may qualify for disability benefits. This, of course, illustrates why it is important to provide detailed information regarding the medical treatment history and the work history.
Providing information about the Medical History and Work history
Regarding the medical treatment history, the person filing for disability should be sure to include all sources of treatment back to the time their disability began. They should also include every current source. This is because Social Security will need to determine whether or not the person is currently disabled and also what their date of onset is, which is critical for determining how much back pay they may be eligible to receive.
Full names and addresses of treatment sources, however, is also important so that the disability examiner who processes the case will not have any difficulty obtaining the needed medical records. In most cases, the single largest case processing delay has to do with obtaining medical records and in many cases this is related to incorrect or incomplete information provided at the time of application.
Regarding the work history, the person filing for disability should include their entire work history for the 15 year period prior to becoming disabled. This should include job titles and detailed descriptions of job duties. As previously stated, Social Security uses this information to evaluate your ability to perform any of your past work activity and the chance that you might be able to do other kinds of work considering your job skills.
When the claim involves SSI
If your disability claim involves SSI, you should also be able to provide information about your income and resources (resources are assets). SSI is a need based disability program consequently it is subject to income and resource limits. During your disability interview, the claims representative will expect you to answer questions about your bank accounts, vehicles, insurance policies, land, or any other resources that could be easily converted to cash. Meeting resource and income limits determines if you are eligible for this program.
Note: See What are the Assets that count for SSI Disability?
While you are in your disability interview, a claims representative uses the information you are providing to complete your disability report form SSA 3368. This form contains your medical source contact information along with your treatment dates, medication, and testing. The form also lists types of work you have done in the past fifteen years.
They will also have you sign a medical release form that gives Social Security permission to request your medical records.
Once they have completed all necessary forms, your disability claim file is transferred to a state disability agency (DDS, or disability determination services) for a medical disability decision.
It would not be farfetched to say that a disability claim could be won or lost based on the information a disability claimant provides during their disability interview. Therefore, it is important to be prepared to answer questions thoroughly during the disability interview, because it provides better information to the disability examiner who is making the medical disability determination.
Continued at: What to bring to a disability interview when you apply
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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