When does social security consider you eligible for disability benefits?

There is a definition of disability that is used by the social security administration for both the Social Security Disability and SSI disability programs. Though it might surprise some people, the definition is just as dependent on vocational information as it is on medical information.

What does the SSA definition of disability say? Basically that, to qualify for disability benefits, a person's condition (or conditions, and they can be either physical or mental, or more than one of each) must be severe enough that they no longer have the ability to work and earn a substantial and gainful income.

The way the definition is applied is as follows:

A disability examiner working on a disability claim will thoroughly review an applicant's medical records to determine what their limitations are.

For physical limitations, the disability examiner will review the records and then rate the claimant as being able to perform heavy, medium, light, sedentary, or less than sedentary work activity. Less than sedentary will always result in a disability approval, while being rated at a higher work activity level may result in an approval depending on other factors.

Those factors include what the claimant did in their past work (and what those jobs required), what the claimant's work skills are, how well educated they are, and how old they are. The older you are, the more consideration the disability system will give since it is generally assumed that with greater age has a person has fewer job opportunities.

The physical rating that a claimant receives (known as their RFC, or residual functional capacity, rating) will be used to determine if they receive disability benefits. However, claimants are also rated for their mental limitations.

An MRFC, or mental residual functional capacity rating, is conducted if the claimant indicated on their disablity application that they had a cognitive problem (learning disability or memory problems, or limited IQ) or psychiatric problems (depression, bipolar disorder).

The MRFC rating will indicate whether or not the claimant has any of the following: difficulty learning new tasks, performing tasks that require attention and concentration, working in a changing work environment, integrating with co-workers and supervisory personnel, and a wide range of other mental characteristics that would impact their ability to persist in a work environment.

The mental and physical ratings a claimant receives from a disability examiner--and the medical and the mental consultants that the disability examiner works with in his or her claims processing unit--will be used to determine several things. The first will be whether or not the claimant still has the ability to work at one of their former jobs. If that is not possible, the examiner will decide whether or not the claimant can do some type of other work. If that is also not possible, the examiner may decide that the claimant is disabled.

continued at: Eligibility for Disability Benefits as Viewed by Social Security

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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