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 Medical Requirements for Receiving Social Security Disability or SSI

Medical Eligibility Requirements for both Social Security Disability and SSI

To receive either SSD or SSI disability benefits, you must obviously be able to prove that your mental or physical condition is disabling. You prove this by the information contained in your medical records and potentially also by statements submitted by the physicians who have treated you.

Note: the social security administration does not attempt to obtain medical source statements, also known as RFC, or residual functional capacity statements from a claimant's treating physicians. However, if you go to a disability hearing before an administrative law judge and you are represented by a disability lawyer, there is a good chance that your lawyer will attempt to get such a statement to add to your case since it can often make the difference between winning or losing a claim at a hearing).

What does the social security administration mean by "disabling"?

Social security does not take the viewpoint that your condition must render you completely unable to function. It does take the position, though, that your condition must be severe enough that it prevents you from able to work at any job and earn the income limit for SGA, or substantial gainful activity, for a given year. This includes working at jobs you have held in the past, and other jobs that the social security administration may consider you capable of performing based on your medical and vocational profile.

Obviously, then, winning a claim for social security disability or SSI will boil down to specific eligibility requirements, namely proving that you have certain physical and mental limitations that make it impossible for you to engage in work activity while earning SGA-level income.

Proving such limitations is based entirely on extrapolating from the information contained in your medical records, which can be a difficult task considering that most medical records and mental health records make little reference to how the condition actually affects one's ability to engage in and perform normal daily activities.

Winning a disability claim also means properly identifying a claimant's prior jobs and accumulated work skills so that it can be demonstrated that the claimant's functional limitations are not up to the task of going back to a former job or performing some type of other work for which those skills could come into play.

In either case (medical factors or vocational factors), the entire evaluation of a disability claim is largely beyond a claimant's control at the initial claim, or disability application, level. The same is true of the first appeal level, the request for reconsideration. This is because at both levels, the claim is decided by a disability examiner and neither the claimant nor the claimant's disability representative (who can be an attorney or a non-attorney) is significantly involved.

At the disability hearing level, however, the claimant, and the claimant's disability attorney if he or she has one, assume a much greater role. This is because, unlike the prior levels, the claimant will meet the decision-maker (an administrative law judge) at the hearing.

Also, the social security administration no longer gathers medical records on the claimant's behalf once the case moves beyond the first appeal, the request for reconsideration. So, at a hearing, whatever new records are presented, or whatever physician statements are presented, these will have been obtained and submitted by the claimant and/or their disability attorney.

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

Related pages:

Who qualifies for disability? - Qualifying is based on evidence of functional limitations
The Social Security Disability Approval Process and the Criteria for Decisions
How does Social Security Disability decide that you cannot work?
How do you Win Benefits under Social Security Disability or SSI?
Medical Disability Requirements for SSD and SSI
The non-medical Disability Requirements for SSD and SSI

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.

How to file for disability, SSD or SSI
How to file for Disability and what medical conditions qualify
How long will it take to get disability?
What if your disability gets denied?
How to get disability with a mental condition
How long for Social Security Disability Back pay
Social Security Disability SSI eligibility