The ultimate determination of whether or not a claimant will receive SSI disability benefits (after filing a claim, and perhaps filing multiple appeals) will rest on the claimant’s medical records. However, it’s not really as simply as that. A claimant’s records need to establish that the claimant has functional limitations (the reduced ability to engage in various activities of daily living) that basically make it impossible for the claimant to work and earn what social security refers to as substantial gainful activity, i.e. a substantial and gainful income.

This segment of Disability Audio describes briefly how a claim is initially worked on by a disability examiner at disability determination services. Of course, the very first task that the examiner will accomplish will be to request the claimant’s medical records. So, it becomes obvious at the outset that the information contained in those records are the core of a claimant’s case. And for that reason, claimants need to provide accurate lists of their various medical treatment sources. Because in far too many cases, claimants do leave off information about various sources of treatment and doing so can potentially disadvantage a claim by giving the disability examiner less information with which to work.

Other Posts

Social Security Disability Eligibility
Filing for Disability
Will I be Found Disabled for Social Security Disability?
Social Security Disability Claim Decisions
Applying for Disability with Fibromyalgia and Fibrofog
Lupus and Social Security Disability Benefits

This post focuses on providing a basic explanation of how the social security disability and SSI disability process works. The post does not address the disability appeal process (typically, when I do this, I focus on the first level appeal, the request for reconsideration, and the second level appeal, the request for a disability hearing before an administrative law judge), but, rather, discusses how claims are typically initiated (by calling a local social security office) and, subsequently, what happens after.

To recap, after a disability application is taken by a social security employee known as a CR, or claims rep, the claim is sent to the disability determination services agency in that particular state (in most states, the agency actually is called DDS, but in other states it goes by the moniker “Bureau of disability determination” or “Disability determination Unit” or “Disability determination division”). Once received at that agency, the case is given to a disability specialist, also called a disability examiner, who will handle the task of evaluating both the claimant’s medical history–via records that are gathered from the the sources that are indicated by the claimant at the time of application–and also the claimant’s work history.

Most claimant’s can easily guess why medical records will need to be obtained from their various treatment sources. However, some may not be entirely clear as to why information regarding their work history and individual jobs needs to be gathered. Well, the answer is simply this: the SSD and SSI disability programs issue decisions that are both medical and vocational in nature.

In other words, to receive disability benefits in either program, the federal government does not require that an individual be completely physically or mentally incapacitated (they must be 100% disabled, but as you’ll see, disabled and incapacitated are not necessarily the same thing). Instead, the social security administration requires that, in addition to lasting a minimum of 12 months, a claimant’s condition must simply be disabling to the extent that they cannot engage in their past relevant work (certain jobs performed within the past 15 years) and, additionally, cannot engage in other forms of work that they might, under normal circumstannces, be able to switch to based on their age, education, and acquired working skills.

To make this type of medical-vocational determination, of course, the social security administration, through the disability examiners who process claims for it in the various state agencies, must be able to A) determine what a claimant’s current physical and mental limitations are and B) must be able to compare these rated limitations to what was required of a claimant in their past jobs, as well as compare these limitations to other jobs for which the claimant might ordinarily be suited to take up.

Other Posts

Social Security Disability Eligibility
Filing for Disability
Will I be Found Disabled for Social Security Disability?
Social Security Disability Claim Decisions
Applying for Disability with Fibromyalgia and Fibrofog
Lupus and Social Security Disability Benefits