Qualifying for Disability - The Process

To qualify for disability benefits under either the SSD or SSI disability program, you must prove, through the information contained in your medical records, that you no longer possess the ability to work at a level that would be considered to be substantial and gainful employment.

The definition of disability does not state that a person must be incapable of working. It simply states that a person cannot possess the ability to work and earn at least a certain income level. Therefore, if you file for disability, or currently receive disability benefits, you are allowed to work and have monthly earned income as long as your earnings are below the level of SGA, otherwise known as substantial, gainful activity.

The process of qualifying for disability benefits means that your medical records will be reviewed by the social security administration. From a review of the records, a disability examiner (at the disability application or request for reconsideration level) or an administrative law judge--who specializes in disability claims at social security hearings--will be able to determine what your level of function is.

This is known as residual functional capacity and it will allow the decision-maker to determine if A) you have the ability to do one of your former jobs at the SGA earnings level or B) do some type of other work at the SGA earnings level.

If your functional limitations are great enough, it may be decided that you cannot be expected to return to one of your former jobs (performed within the 15 year period prior to becoming disabled, which is known as the relevant period), and it may be further expected that you cannot switch to some type of other work.

Whether or not you will be expected to go back to a former job or do other work that is based on your age, education, and work skills will depend on how severely limited you are thought to be, based on the information in your medical records.

However, work history is just as important as medical history in the disability evaluation process. A review of your past jobs will allow the decision-maker to determine if you can still work at all.

For example, if your current physical limitations are for light work, and your past jobs have all been sedentary, there is a strong likelihood that you will be denied on the basis of being able to return to your past work.

In another example, if you are limited to light work by the disability examiner or the judge, and your past work was at a medium level, then social security will not be able to deny you on that basis (that you can do your past work).

At that point, the consideration would be whether you have the skills and training to do some other type of work. And at that stage of the process, your age and education, and the physical and/or mental limitations that you possess would also be taken into consideration in what is known as the sequential evaluation process.

To qualify for disability, both your medical history and work history must provide the right information. Your work history must establish what you have actually done in your employment history. This will allow the decision-maker on your claim to discern what it is you may still be capable of doing with regard to work activity. Therefore, you should not make the mistake of supplying only partial or incomplete information about your work history. Instead, be careful to do the following:

1. Give full dates of employment. How long you did a job can determine if it is even relevant to your case.

2. Give accurate job titles. Your jobs will actually be identified in a department of labor publication so that the decision-maker can look up your job's physical and mental requirements and also the skill levels of each job--which may determine if you have the ability to use those skills in other work.

3. Give full descriptions of the work that you performed on each job. While this may seem tedious, good descriptions can help avoid a situation in which one or more of your jobs are misidentified.

Remember, disability examiners and administrative law judges are not vocational experts. And they certainly cannot read your mind. To determine what type of work you did and whether or not you can be expected to go back to that work, or be expected to do another type of work, they will be entirely dependent on the work history information that you provide.

Make no mistake: some individuals are turned down for disability because they failed to give accurate descriptions of the jobs they held. In many cases, this is rectified at a disability hearing where a claimant has a disability attorney who is competent enough to see the mistake that was made earlier. But even when this happens, the result is still many months of wasted time.

Continued at: Qualifying for Disability - What is Social Security Looking for?

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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