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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 does a Social Security Disability Examiner decide a case?



 
Continued from: Who will decide my Social Security Disability claim?

What information is used by a disability examiner to make a decision on a claim? The examiner will rely on the following:

1. The information contained in the medical records. The medical records will be used to interpret what the claimant's RFC, or residual functional capacity is. This is a measurement of what a person can still do despite their condition. If a person is rated with an RFC that is less than what their past jobs required of them, they may be considered disabled if it is also true that they do not have the ability to switch to some form of other work.

2. The information contained in any statements obtained from the claimant's doctors. Statements from a doctor can help support a claimant's disability case if they go so far as to point out how limited the claimant is, i.e. how their condition restricts them. The statement should cite objective findings and should also give some indication as to the claimant's prognosis.



So, obviously, a statement from a doctor that simply says that their patient cannot work will not be enough. The statement must describe how the claimant is limited. For example, does the individual have difficulty sitting or standing, or lifting more than a certain amount of weight, or difficulty with grip strength, or even trouble seeing and hearing. Any physical shortcoming should be noted.

In addition to physical limitations, a claimant's medical treatment specialist (e.g. psychiatrist) may be able to indicate any mental difficulties the claimant has, such as a reduced ability to comprehend, sustain attention and concentration, recall information, or learn tasks.

3. Information regarding the claimant's work history. The disability examiner will not only review the medical records but will look at the various jobs the individual has worked prior to becoming disabled. This will be done so that the examiner can compare the claimant's current range of physical and mental abilities (and limitations) to the demands of their past jobs.

In many cases, the conclusion will be that the claimant is so limited that they are unable to go back to one of their former jobs. However, the process does not end there. The examiner also looks at past jobs to determine if the individual has the necessary skills (in combination with their age and education) to perform some type of other work. Very often, individuals who are found to be unable to return to their past work are still denied for disability because it is decided that they can do "other work".

Denials based on the ability to do other work happen frequently at the first two levels of the system and there is really nothing a claimant can do regarding this. However, at the disability hearing level, a claimant who is represented may be much more likely to prove to the administrative law judge that they can neither return to past work or do other work.

In some cases, this will be because the claimant's past jobs were previously improperly classified. In other cases, it will be because the judge has brought in a vocational expert to give testimony and the claimant's Social Security Disability attorney will be successful in challenging the statements made by the expert.

More at: Who makes the decision at the disability hearing level?








Essential Questions

What is the Social Security Disability SSI list of impairments?

Can you work while getting or applying for Disability?

How Often Does Social Security Approve Disability The First Time You Apply?

Tips for getting Social Security Disability or SSI benefits approved

What medical conditions will get you approved for disability?

What kind of Mental Problems Qualify for Disability?

Receiving a Disability Award Letter

Conditions Social Security will recognize as a disability

Previously answered questions regarding SSD and SSI

Applying for disability in your state



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Social Security Disability SSI Questions

The listings, list of disabling impairments

Can a mental illness qualify you for disability?

Disability Lawyers prevent unnecessary denials

How much Social Security Disability SSI back pay?

How to apply for disability for a child or children

Filing a Social Security Disability SSI application

Filing for disability - when to file

How to apply for disability - where to apply

Qualifications for disability benefits

How to Prove you are disabled and Win your Disability Benefits

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Related pages:

What does a Social Security Disability Examiner do?
Can I Talk To the Disability Examiner Working On My Case?
How Does A Social Security Disability Examiner Determine a Person’s Functional Limitations?
What happens if the Social Security Disability examiner cannot find all the needed medical records?
How long does it take for an examiner to review a disability case?
Will the the SSA Examiner Call or Contact me about my Social Security Disability or SSI Claim?
What tools are used by a Social Security Disability Examiner to Make a Claim Decision?
After you file for SSD, the Disability Examiner may contact you for additional information
Social Security Disability and Bilateral Hearing Loss
The regulation for SSDI Retroactive Benefits?



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.