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Your Doctor's Opinion: Navigating Your Burden of Proof

Updated: Jul 25, 2023

The Social Security Administration (SSA) plays a crucial role in providing financial support to individuals with disabilities. One of the key aspects of the SSA's process is determining whether an individual qualifies as disabled according to their guidelines. It is important to understand that the final decision lies with the Commissioner of the Social Security Administration, and this blog aims to shed light on the factors considered in disability determination.

Doctor's Opinion and Disability Determination

Contrary to popular belief, the opinion of an individual's doctor regarding their disability is not binding on the Social Security Administration. While a doctor's assessment is certainly valuable and taken into consideration, the SSA takes a holistic approach when evaluating disability claims. This is primarily because disability determination involves various factors beyond the medical aspect.

Factors Considered in Disability Determination

The Social Security Administration not only assesses an individual's medical condition but also evaluates other factors that impact their ability to work and function. These factors include age, education, and work history. By considering these additional elements, the SSA aims to make a comprehensive assessment of an individual's ability to engage in substantial gainful activity (SGA), which refers to work that provides a significant income.

Understanding the Impact of Disability

Two individuals may have the same medical condition, yet experience vastly different effects on their ability to function. To illustrate this, let's consider a scenario involving pregnancy, although it is not considered a medical impairment under Social Security Administration guidelines. Imagine two pregnant women, both with the same condition. However, one continues working until giving birth, while the other requires three months of bed rest before delivery. Despite the shared medical condition, the impact on their ability to function is entirely different.

The Functionality Assessment

When making disability determinations, the Social Security Administration evaluates an individual's ability to perform certain tasks necessary for work. This assessment considers factors such as sitting, standing, attending work, concentration, staying on task, and interacting with others. By focusing on an individual's functional abilities, the SSA gains insight into how their disability affects their work-related activities.

Combining Functionality with Work History, Age, and Education

Once the Social Security Administration determines an individual's ability to function, they combine this assessment with the individual's work history, age, and education. This combination is necessary to evaluate the feasibility of performing any previous work or adjusting to new employment opportunities that may accommodate their limitations.


Understanding the disability determination process is crucial when navigating the Social Security Administration system. While a doctor's opinion holds importance, the Commissioner of the SSA has the final say on whether an individual qualifies as disabled.

By considering factors beyond the medical condition, such as age, education, work history, and the impact of these factors on functionality, the Agency aims to make fair and comprehensive determinations.

Being aware of these factors can help individuals present their case effectively when seeking disability benefits.

©2023 Noel Anschutz / Professional Advocates, Inc.

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