How Does the Social Security Administration Decide Whether I'm Disabled?

How Does the Social Security Administration Decide If I’m Disabled?

When you apply for Social Security Disability Insurance (SSDI), a key factor in deciding whether you will receive disability benefits is the determination of whether your condition meets Social Security’s strict definition of being disabled.

A state agency called Disability Determination Services (DDS) evaluates whether you are disabled based on a series of factors including:

  • Supporting medical evidence of the disability
  • The duration of your disability
  • Your ability to work and earn income
  • Your employment history and participation in the Social Security system.

If you have applied for disability benefits and been turned down, a knowledgeable disability benefits lawyer can review your application and help you file an appeal. Working with an SSDI attorney who knows the system and what evidence is needed will improve your chances of making a successful application or appeal.

How Disability is Determined

There is a multi-step process to make a disability determination.

First, the application reviewers will review your medical records and evaluate whether your injury or disease is severe. They will assess whether your condition creates serious barriers to holding a job for a long period of time. Workers who have a short-term disability are not eligible for SSDI.

Second, they will compare your condition to the published Listing of Impairments known as the Blue Book, which lists many permanent or terminal medical problems that are considered severe enough to prevent an individual from being gainfully employed. If your health issue matches or is similar enough to one of the described conditions, you will pass one of the tests for receiving disability benefits. If your disability does not match one of the listed impairments, you must present medical documentation that shows that your condition leaves you incapacitated.

Third, the claims examiners will rate your ability to continue performing your job. This is known as your residual functional capacity. The examiners at Disability Determination Services use a form called a Residual Functional Capacity (RFC) assessment to compare your abilities and limitations to the requirements of your former job. Even if you cannot perform the work that you previously did, you may still have the ability to perform other work. Your doctor understands how your disability affects your life. It can be helpful to have your doctor complete an RFC discussing your abilities and work limitations.

The DDS weighs your work experience, age and education along with your limitations to determine if you are capable of any substantial gainful employment. If they conclude that you could still work in some capacity, you may be denied disability benefits.

If you have a listed disability, you also must have a history of employment and payment of Social Security taxes to qualify for SSDI benefits.

What Qualifies as a Disability?

There are many medical conditions that Social Security recognizes as disabling conditions when the effects are severe enough and limit your ability to work. More than 200 conditions qualify for compassionate allowances, such as acute leukemia and inoperable bone cancer, breast cancer and bladder cancer.

The following are some of the common conditions that qualify for disability:

  • Cancer that has advanced or is inoperable
  • Malignant growths or tumors
  • Musculoskeletal disorders such as spinal problems and impairments involving the joints and bones, complex regional pain syndrome, fibromyalgia
  • Cardiovascular conditions such as coronary artery disease and chronic heart failure
  • Blood disorders including sickle cell disease and hemophilia
  • Neurological disorders such as multiple sclerosis, cerebral palsy, traumatic brain injury and Parkinson’s disease
  • Sensory disorders including loss of vision, loss of hearing, macular degeneration, and Meniere’s disease
  • Digestive tract disorders such as inflammatory bowel disease, liver disease, diverticulitis, GERD, and hepatitis
  • Mental disorders including anxiety, Asperger’s syndrome, autism, bipolar disorder, and schizophrenia
  • Respiratory system disorders including asthma, cystic fibrosis, emphysema, lung transplant, and sleep apnea
  • Skin disorders including severe burns
  • Blood clots
  • Immune system disorders including multiple sclerosis (MS), rheumatoid arthritis, lupus and HIV/AIDS

Compassionate Allowances

If you have medical documentation of a condition that qualifies for a compassionate allowance, your disability application may receive expedited handling. A knowledgeable attorney can review the details of your medical condition and help you understand whether it meets the criteria to make you eligible for disability benefits.

Disability Benefits Available

If you have become incapacitated by illness or injury and can no longer work for a living, you may qualify for Social Security disability benefits. The two types of benefits available to disabled workers are Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).

SSDI—Social Security Disability Insurance payments are paid to disabled workers, their widows or widowers, their children, and adults who have been disabled since childhood. To be eligible, a disabled worker must have a recognized disability and have worked and contributed to the Social Security system long enough to qualify for benefits.

SSI—The Supplemental Security Income program is an income-based program makes monthly cash assistance payments to people who are blind and disabled and have limited income and few financial resources. Your income and resources have to be very limited to qualify.

How to Avoid Mistakes When Applying for Disability Benefits

If you are considering applying for disability benefits or appealing a denied claim, an experienced Oklahoma City disability attorney can help you navigate the complicated disability claims process. Attorney Philip D. Ryan has successfully represented clients seeking SSDI and SSI benefits for nearly 30 years. Request a free copy of Philip D. Ryan’s book, The 7 Costly Mistakes That Can Ruin Your Social Security Disability Claim. Click on the link to request a copy.

Hiring a knowledgeable SSD attorney can make the process easier. Our disability attorneys at Ryan Bisher Ryan & Simons work with SSDI applicants throughout the Oklahoma City area. Contact us to arrange your free initial consultation.