Who Makes the Decision at the Social Security Disability, SSI Hearing Level?
If your The Social Security Disability Approval Process and the Criteria for Decisions.
However, at the hearing level, the process is still essentially the same. The ALJ will review the medical evidence looking for signs of limitations that might prevent a person from engaging in normal daily activities.
When the claimant is a child (such as for SSI child benefits), being unable to engage in normal daily activities would typically mean having difficulty engaging in age-appropriate activities. For children who are school-age, this will typically mean having to examine evidence as to the child's ability to perform school work.
For this reason, child disability cases will often involve reviewing IQ testing, achievement testing, grades, IEPs, and questionaires from the child's teachers, all in the attempt to determine whether or not the child is being impaired from engaging in what is thought to be normal and expected for the child's age.
When the claimant is an adult, the emphasis will still be on evaluating whether or not the individual can engage in normal daily activities.
However, here the emphasis will be on determining whether or not the individual is capable of A) performing work activity and B) working and earning at least a certain minimum threshold of income each month.
Item B is important because the social security administration has taken the position that even individuals with disabilities may still be able to work, even if they cannot work to the extent of being able to earn a livable wage.
It is for this reason that disability benefit applicants and recipients are not necessarily penalized for working, though their benefits may be reduced or stopped altogether if they demonstrate the ability to work in excess of a certain limit (that limit is known as the substantial gainful activity, or SGA, level).
How does the administrative law judge (or a disability examiner if the case is being worked on at the lower levels of the system) evaluate whether or not a person can work? This decision process involves reviewing the claimant's past work and comparing that to the physical and mental capabilities they currently possess.
If the evidence suggests that the individual cannot return to a former job (potentially any job they have done in the last 15 years) or perform some type of other work they have never done but for which their education, physical and mental condition, and work training might qualify them for, then it is likely that they will be approved for disability benefits.
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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