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Behind the Scenes: Demystifying the Social Security Disability Determination Process

Updated: Jul 25, 2023

Social Security provides disability benefits to individuals who are unable to work due to a disabling condition. The determination of disability involves a comprehensive evaluation process. In this blog post, we will explore the steps involved in how Social Security determines disability.

1. Eligibility for Disability Benefits:

To be eligible for social Security disability insurance benefits, you must have worked in jobs covered by Social Security and earned enough credits. To be eligible for Supplemental Security Income you must not over certain resource limits Additionally, your disability should be expected to last for at least one year or result in death.

2. Filing an Application:

The first step in the process is to file an application for either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. This can be done online, over the phone, or by visiting a local Social Security office.

3. Gathering Medical Evidence:

Social Security requires extensive medical evidence to support your disability claim. This includes medical records, doctor's opinions, test results, and any other relevant documentation that demonstrates the severity and impact of your condition. It is crucial to provide a comprehensive and up-to-date medical history.

4. The Sequential Evaluation Process:

Social Security uses a five-step sequential evaluation process to determine disability. Let's delve into each step:

a. Substantial Gainful Activity (SGA):

Social Security checks if you are currently engaged in substantial gainful activity, meaning whether you are working and earning above a certain income threshold. If your earnings exceed the SGA level, you are generally not considered disabled.

b. Severity of Impairment:

The agency assesses the severity of your impairment(s) and determines if it significantly limits your ability to perform basic work activities. This evaluation takes into account the impact of your condition on your daily functioning and work-related tasks

c. Listing of Impairments (Blue Book):

Social Security maintains a comprehensive "Blue Book" that lists various medical conditions and their specific criteria. If your condition meets or equals the requirements outlined in the Blue Book, you may be considered disabled without further evaluation. It is essential to match your condition to the specific listing criteria.

d. Ability to Perform Past Work:

If your condition does not meet the criteria in the Blue Book, Social Security evaluates whether you can perform the work you previously did. They consider your skills, education, and experience to determine if your condition prevents you from engaging in your past work.

e. Ability to Perform Other Work:

If you are unable to perform your past work, Social Security assesses your ability to adjust to other types of work based on factors such as your age, education, work experience, and transferable skills. They consider if there are any jobs available in the national economy that you could perform despite your limitations.

5. Decision and Appeals:

After considering all the evidence and evaluating your case at each step, Social Security will make a decision regarding your disability claim. If your claim is denied, you have the right to appeal the decision within a specified timeframe.

Determining disability for Social Security benefits involves a thorough evaluation process. It requires providing extensive medical evidence, meeting the specific criteria outlined in the Blue Book, and demonstrating the impact of your condition on your ability to work. Understanding the process can help applicants navigate the system effectively and seek the necessary support during the disability determination journey.

©2023 Noel Anschutz / Professional Advocates, Inc.

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