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A brief look at how the Social Security Administration review claims, P.2

In our last post, we began speaking about the decision-making process utilized by the Social Security Administration when reviewing applications for disability benefits. As we noted, the first two considerations are whether the applicant is currently working, and whether his or her condition is severe enough that it interferes with basic work-related activities.

If an applicant receives a positive assessment with respect to these first two criteria, the next consideration is whether his or her condition can be found in the agency’s official listing of disabling conditions. This list categorizes the conditions which have been deemed severe enough that they automatically qualify an applicant for disability. Conditions which aren’t on the list can still qualify an applicant for benefits, but the agency has to determine whether the non-listed condition is of equal severity to a listed condition. Some conditions not only automatically qualify an applicant, but qualify an applicant for expedited approval of their claim. 

Applicants whose condition is not listed or equal in severity to a listed condition are not automatically disqualified, but are subjected to scrutiny regarding their ability to perform work they previously performed. If the applicant’s condition does not allow him or her to engage in work previously performed. If not, the applicant is disqualified; if so, the next question is whether the applicant can perform any other type of work. The agency is supposed to consider various factors in making this determination, such as the applicant’s age, past work experience and education. If the agency deems that the applicant is able to perform other work, the claim is then denied.

Social Security determinations are, as can be seen, very fact specific, and it is important to provide a high level of detail about one’s condition to ensure the more accurate decision. Working with an attorney experienced in the Social Security claims process can help ensure that applicant puts together the most thorough application possible, and that additional relevant information is provided to the agency when necessary.

Source: Social Security Administration, “Disability Planner: How We Decide If You Are Disabled,” Accessed Feb. 2, 2016.

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