Permanent Disability Qualifications for SSD and SSI

In claims where at least one condition is judged to be severe, the disability examiner or judge will determine whether or not the claimant's condition is severe enough to keep them from engaging in work activity while earning at least a substantial and gainful income.

Remember that for social security administration purposes, a claimant is allowed to work and earn income while either apply for disability or receiving disability. However, for such individuals, the qualifications criteria mandates that their condition must be severe enough that, although they can work, they cannot earn at least a substantial and gainful income (to see the definition of this, see SGA).

If a person has a severe condition that prevents them from earning a substantial and gainful income, will it result in their being given a Social Security Disability award (or SSI award as the case may be)?

Not necessarily. The impact of a claimant's condition on their ability to work must last for at least one full year. And even if the individual is awarded disability benefits, they will still periodically undergo a review of their claim to determine if they are still disabled.

This is because the social security administration views disability as "permanent disability". And currently the benchmark for determining if a condition is permanently disabling is to see if it has lasted a full year, or, through a projection, determining if it will last a full year.

How does a disability examiner or a disability judge determine whether or not a claimant's condition will be severe enough to prevent substantial and gainful work activity for at least one full year?

To some extent, this is a subjective call. It certainly always relies on the information that is recorded in the claimant's medical records. Unfortunately, most medical records do little to document the following:

A) If a claimant's condition is disabling;

B) What limitations and physical and mental restrictions result from the claimant having a particular condition;

C) How long the condition will last;

D) What impact the claimant's condition will have on their ability to engage in normal daily activities, including work activity.

Because most doctor's notes do not provide this type of information in any abundance (if at all), it is generally wise for a claimant (or the claimant's disability lawyer if they have one) to try to obtain a detailed statement from a doctor.

Such statements are often ignored by disability examiners who do not give a claimant's treating physician the proper weight; however, at a disability hearing an administrative law judge will generally pay close attention to a physician's statement if it is detailed and essentially conforms to the information recorded in that same doctor's treatment notes.

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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