Overview of Disability

Disability Back Pay

Disability Requirements

Disability Applications

Disability Advice Tips

How long do cases take?

How to win Disability

SSD Mistakes to avoid

Disability for Mental

What if you get denied?

How to file Appeals

Disability through SSA

SSI Disability Benefits

Disability for Children

How do I qualify for it?

Working and Disability

Disability Award Notice

Disability Lawyer Q&A

Disability Conditions List

What is a disability?

Your Medical Evidence

Filing for your Disability

Disability Eligibility

SSD SSI Definitions

Recent Questions

SSDRC Disability Blog

The Social Security Disability Approval Process and the Criteria for Decisions

What follows is a short description of the disability approval process, which will hopefully help claimants or even potential claimants understand the process by which social security disability claims are approved.

1. After an application for disability benefits is made to social security, the case is transferred to the state agency responsible for making disability determinations, DDS. There, it is assigned to a disability examiner who will evaluate the claim.

2. The disability examiner sends requests for medical records to all physicians and medical facilities listed by the claimant on the disability application. After receiving them, the disability examiner will evaluate the records; however, it is important to note that it could take months to receive the requested records back from doctors, hospitals, or other medical professionals.

3. The examiner may refer to the Social Security impairment listing manual (known as the blue book and published by the social security administration under the title "Disability Evaluation under Social Security") to evaluate the claimant’s physical or mental condition.

Impairments listed in the manual have strict disability criteria, and even being diagnosed with a listed condition will not necessarily result in approval if the medical records do not support the requirements of the listing.

4. In the majority of cases, a claimant will not be approved on the basis of meeting, or equaling, a "listing" in the manual (such as for depression, a specific form of cancer, or a condition of the spine). If it becomes obvious to the disability examiner that the obtained medical records do not support an approval on the basis of a listing, then the examiner will employ an evaluation method known as "sequential evaluation". Using this method will require that the disability examiner do the following:

A. The examiner will determine what the claimant's residual functional capacity is. RFC, or residual functional capacity is simply an assessment of what a person is still capable of doing. If the claimant has one or more physical impairments, then the examiner will determine a physical RFC. If the claimant has one or more mental impairments, then the examiner will determine a mental RFC.

In many cases, of course, the examiner will determine both a physical and a mental RFC. Will the examiner do this with or without the input of medical and psychological consultants? In most cases, the examiner will be required to consult with either a physician or a psychologist who is part of his or her claim processing unit before the final RFC determination (or determinations) can be made.

B. After the claimant's residual functional capacity has been determined, the disability examiner will compare this rating (or ratings) to the requirements of the claimant's prior jobs. This will be done to determine if the claimant has the ability to go back to one of their former jobs.

If it is decided that the claimant cannot go back to one of their former jobs, the examiner will investigate the possibility of the claimant switching to some type of other work (that the claimant has never done before). This will be based on the claimant's work skills, as well as their age, education, and residual functional capacity.

C. If it is determined that the claimant cannot do their past work, or do some type of other work, they will be approved for disability benefits under SSD or SSI. If the claimant can do either their past work (any job they have held for an appreciable period of time in the last fifteen years) or some type of other work, then they will be denied on their claim for disability benefits.

Return to:  Social Security Disability Resource Center, or read answers to Questions

Related pages:

The Social Security Disability Approval Process and the Criteria for Decisions
Disability Approval Chances at the Social Security Reconsideration and Hearing Levels
How will you be notified if you receive an Approval for Social Security Disability or SSI
Social Security Disability, SSI Decisions – What Is the Rate of Approval?
The Social Security Disability Approval
How long does it take to be approved for SSI or Social Security disability?
The Medical Vocational Allowance Approval for Social Security Disability and SSI cases
Can you be denied for disability even if your doctor recommends that you be approved?
When can I expect my first disability check and my back pay check?
Social Security Disability Temporary Benefits and Closed Periods

Information on the following topics can be found here: Social Security Disability Questions and in these subsections:

Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI

These pages answer some of the most basic questions for individuals who are considering filing a claim.

Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
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?
How to Prove you are disabled and qualify to win disability benefits
How do you prove your disability case if you have a mental condition or impairment?
Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria