It’s apparent to every individual who decides to file for social security disability or SSI disability that an applicant must have an impairment of some kind, either physical or mental in nature, or a combination of impairments (that may be physical, mental, or both). Furthermore, the great majority of applicants for SSD and SSI benefits realize that the strength of an adult’s claim will hinge on the extent to which their ability to engage in work activity will be affected.

However, few disability claimants typically have any concrete idea as to how the social security administration, through its use of judges and claims examiners, actually makes the determination as to whether or not a claimant can work.

The answer is actually fairly simple. Disability adjudicators, the individuals who make decisions on claims (judges and examiners) evaluate a claimant’s medical records to ascertain if their impairment is severe. The records are also evaluated in an attempt to learn how the claimant’s condition functionally limits them and interferes with their ability to perform work activity. By rating a person’s current abilities and limitations, and then comparing this rating to what was required in the jobs previously held by the claimant, social security can determine whether or not a return to past work is possible. Social security also uses the claimant’s work history information and their medical information to determine if the claimant might be found capable of performing some other type of work, assuming they cannot return to their past work.

However, one overriding factor in this process is whether or not the claimant worked and received earnings (or is currently working and receiving earnings) at the substantial gainful activity level. As this segment explains, SGA is a monthly earnings limit that cannot be exceeded by anyone filing for disability or receiving disability benefits. The amount is indexed to the cost of living and, therefore, does change annually.

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Though an individual will usually file a claim for social security disability or SSI disability at a local social security office, the case itself (and by this we mean the evaluation of an individual’s medical records and work history), is not actually worked on by the social security administration. In actuality, a social security office will simply take a person’s claim and then send it off to an entirely separate agency where the case will be examined and decided by a disability examiner.

Disability examiners do not have medical training; but, they are trained to review medical records to look for signs of an individual’s loss of functional ability. For instance, a claimant who applies for disability may allege on their disability application that they have a shoulder injury or pain in their lower back. However, the allegations of such complaints will mean little to a decision-maker unless the medical records that are being read and evaluated actually indicate (or lead the examiner to conclude) that the claimant has loss of function such as, for example, a reduced ability to reach, to lift, to bend, to sit, to stand, etc.

Loss of function, and a claimant’s remaining level of function (known as residual functional capacity) allow disability examiners to decide whether or not a person filing for benefits actually has the ability to go back to work, either in one of their former jobs or in some form of other work.

Obviously, to make this assessment, a social security disability claims examiner needs access not only to a claimant’s medical records but also information regarding their work history. By reviewing the work history, a disability examiner can learn more about the duties and physical and mental requirements of the claimant’s former jobs to determine if they can return to one of these jobs. By reviewing the work history, a disability examiner can also learn if the claimant has job skills that might allow them to perform some other type of work.

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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