Medical Disability Requirements for SSD and SSI

The disability eligibility requirements of Social Security Disability and SSI are the same, meaning that the definition as to what constitutes a disability is the same, and how a person's medical records and work history is evaluated is the same. However, the non-medical requirements of both programs are a bit different from each other.

On this page, we will discuss the medical requirements of SSD and SSI, and on the following page (link below), we will discuss the non-medical requirements of SSD and SSI.

Medical Disability Requirements

To be eligible for SSD or SSI benefits, your history of medical treatment must show that you have at least one impairment that could be considered severe. To be severe, it must reduce your functionality; in other words, the impairment must reduce your ability to engage in normal activities of daily living, which, of course, can include work activity. How does the social security administration assess whether or not your physical and/or mental functionality is impaired?

1. Social security will evaluate your medical records, looking through your physician's treatment notes, your lab reports, the interpretations of xrays, MRI scans and CT scans, and hospital admission and discharge summaries to find evidence of functional limitations.

2. Social security, through a disability examiner, will ask you (and often a third-party contact person as well, such as a friend, neighbor, or relative) about the activities that are a part of your normal day. This is done in an attempt to gauge what activities you may have trouble with. For example, disability examiners who are conducting an ADL (activities of daily living) phone call to a claimant will typically ask the claimant how well they are able to prepare meals, do household chores, and take care of personal hygeine tasks.

Some claimants may wonder what daily activities have to do with disability. However, many conditions can have an immediate impact on the ability to perform daily activities. For example, a person with reduced grip strength might have difficulty buttoning clothes or picking up cans of food. A person with shoulder problems might have difficulty putting dishes into a cupboard. A person with memory difficulties might have trouble writing bills or making shopping lists.

Asking a claimant (or the person the claimant listed as a third-party contact) about their daily activities can help illuminate exactly how their condition impairs them and reduces their ability to function. This can be taken into consideration when the claimant's residual functional capacity is rated (all claimants are given physical and/or mental ratings of their remaining, or residual, functional capacity). The RFC rating is compared to the functional requirements of the claimant's past work and the requirements of any other work that the claimant might be considered capable of doing.

What makes a person medically disabled under either the Social Security Disability or SSI program? Basically, that they have a severe mental or physical impairment that is severe enough to prevent them from being able to work and earn a substantial and gainful income for at least twelve months. When a claimant satisfies this criteria, they are considered disabled according to the definition of disability used by the social security administration.

continued at: The non-medical Disability Requirements for SSD and SSI

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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