How does Social Security decide if I am Disabled ?
The process of evaluating disability claims is fairly complex in a number of ways. And to complicate matters even further, the social security administration does a particularly poor job of explaining how the system works, both to individuals who have already filed claims (and perhaps have been denied) and to individuals who are investigating the possibility of filing a social security disability or SSI claim.
Here are a few things that disability applicants should know upfront about the SSA (social security administration) disability system.
1. Though disability applications are taken at social security offices, they are actually processed by disability examiners who work in separate agencies. These examiners handle the task of ordering a claimant's medical records, reading and evaluating those records, and then deciding if a claim should be approved or denied (examiners, of course, make decisions in consultation with medical consultants who are assigned to the units they work in).
2. Claims for benefits are generally approved when the determination has been made that a claimant has a severe impairment that has prevented them (or will prevent them) from earning a substantially gainful income for at least one year, and that the claimant (on the basis of their age, level of education, and current functional limitations) cannot return to their past work and cannot perform some type of other work.
3. Claims for disability benefits are typically denied at the application level (also called the initial claim level) and claims generally face a 70 percent chance of denial. Claims for disability benefits are also typically denied at the first appeal level (depending on the state you live in, this will be known as the review or reconsideration phase) and, historically, claims at this level have been denied at a rate of greater than 80 percent.
The following links also address the question "How does social security decide if I am disabled ?"
Return to the Social Security Disability SSI Benefits Blog
Who is it that actually makes the decision on a disability case ?
How does the social security administration render decisions on claims for the disabled ?
The decision process that is used to decide a Social Security Disability or SSI case
Social Security Disability eligibility criteria ?
How does a person get awarded and receive SSI benefits
When is the right time to apply for disability ?
Possible advice to follow when filing for disability
Getting a decision made on a claim - the length of time it takes