What are the qualifications for disability in Texas?

Both SSD and SSI are federally administered programs. Because of this, there is no difference between qualifying for disability in Texas versus any other state.

Regardless of the state a person lives in, to be successful on a claim for Social Security Disability or SSI, a person must prove that they do not have the capability to work and earn the Social Security earnings limit, known as SGA.

This is proven through the evidence in an applicant's medical records which can include not only treatment notes and reports of bloodwork, imaging studies, and the like, but also detailed statements from individual physicians who have rendered treatment to a patient and are, therefore, in a qualified position to comment as to how that person's condition actually limits their ability to function, in a physical or mental sense.

Before a disability claim can actually be evaluated by a disability claims examiner at a Texs DDS (disability determination services, where decisions on disability applications and reconsideration appeals are made), two initial determinations must be made that do not have anything to do with the medical evaluation of the claim.

Common questions about filing for disability in Texas
The first is whether or not the claimant is engaged in work activity. However, not just work activity. Social Security does not bar someone from applying for disability because they are working. Social Security focuses on how much a person is able to earn despite having their condition. Therefore, their earnings at the time they are filing for disability must be less than the SGA limit (see the link in the second paragraph above).

If an applicant's earnings are above the allowed amount, the claim will be denied before the medical evaluation can be done. And this will occur at the Social Security office.

The second qualification is whether or not a person's condition is considered severe. This determination is made by the disability examiner assigned to the case. In most instances, the claimant will be found to have at least one severe, medically determinable medical impairment.

In those somewhat rare situations where there is not a single severe condition (for example, if a person filed on the basis of having a cold or sore muscles or a minor sprain), the case will be denied for NSI, which stands for non-severe impairment.

Most claims, however, will proceed to the third step of the 5 step evaluation process. This is where the disability examiner will examine the medical evidence to see if the claimant has a condition that satisfies the criteria of a listing in the blue book.

The blue book is the nickname for the Social Security listings of impairments. There are adult listings and there are child listings. In either case, these are listings of medical impairments, divided by body system (for example, respiratory, cardiovascular, musculoskeletal, endocrine, etc), and the specific medical criteria needed for approval.

Most claims are not approved through meeting or equaling the qualifications of a listing. However, this does not mean that a claim that fails to do this will be denied. In fact, the listings do not even make reference to all medical conditions. For example, carpal tunnel syndrome and fibromyalgia are not included in the listings.

When a case cannot be approved through the listings, the qualifications process moves on to determining if the individual can work.

Step 4 of the 5 step evaluation process is whether a person can return to their past work. The following links address this:

What Does Social Security Disability and SSI Include As Your Past Work?
What does social security mean by past work?
How does Social Security Disability get Information about your past work?

In some disability programs if a person cannot do their former job, they may receive benefits. But this is not true with either Social Security Disability or SSI. If a person is found to be incapable of going back to the work they did before, the decision process moves on the next qualification, which is other work.

If a person is found to be unable to do some type of other work, in addition to being unable to return to their past work, they can generally expect to receive disability benefits because they will have met the SSA definition of disability.

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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