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Disability benefits and how SSA determines whether I'm "disabled"

I haven't really seen it spelled out in any of your other posts and was wondering how, exactly, the social Security Administration decides who has a disability that will get benefits and who doesn't? What is the process? I know I can't work, but will that make me disabled in the eyes of the SSA? Thanks

 
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Editor's Response

When you file your disability claim with the Social Security Administration for SSI or SSDI, your file goes to an analyst who will review your medical records and the questionnaires you have filled out and use that information to answer a series of questions.  Attorney Steven Ciulla of Reading provided this explanation of how the process works:

The disability standard used by the Social Security Administration is a complex 5 step sequential analysis. It is different than the test used by the Department of Veterans Affairs and in worker's compensation cases. The Social Security Administration will make the following determinations:

1. Is an applicant engaged in Substantial Gainful Activity or SGA? This will depend on several factors including whether the applicant is an employee or is self employed. If the applicant is engaged in substantial gainful activity, the claim will be denied.

2. Does the applicant have a severe impairment or combination of impairments? If the applicant's impairments are less than severe, the claim will be denied.

3. Does the applicant meet or equal a listing? The Social Security Administration has over 100 listings for specific physical and mental conditions. Each listing contains specific medical or psychiatric criteria. An applicant who satisfies the criteria for a given listing will be deemed disabled and eligible for benefits without further analysis. If an applicant does not meet or equal a listing, the Social Security Administration must proceed to step 4. The Social Security Administration is constantly revising and updating the listings.

4. Is the applicant capable of performing past relevant work given his or her mental and/or physical impairments? This is generally defined as work that was done in the past 15 years. If the applicant is capable of doing past relevant work, the claim will be denied. If not, the analysis must proceed to the final step.

5. Is the applicant capable of performing other work that exist in substantial numbers in the regional and national economy given his or her mental and/or physical impairments? The Social Security Administration bears the burden of proof at this step. If the applicant is incapable of doing other work, he or she must be found disabled and eligible for benefits and vice versa. An applicant's impairments must be severe in nature and prevent him or her from engaging in substantial gainful activity as discussed above. These impairments must actually last or be expected to last in excess of 12 months or result in death.

 

Hope that helps. 

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