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Who determines if I meet Social Security disability requirements?

When you file your claim for disability benefits in the local Social Security Administration (SSA) office, the purpose of your initial interview is just to determine if you meet the non-medical requirements of disability. The Social Security claims representative will make sure that you qualify for benefits based on your age, the number of years you have worked and any current work activity you have.

Assuming that you qualify on all the non-medical issues, your case is forwarded to the Disability Determination Services (DDS) unit in your state, where disability decisions are made. Any medical records you had available at your interview would be forwarded with your claim for benefits.

Once the claims examiner at DDS has your claim, he or she will request any missing medical information and gather information from you, your doctor, your hospitals — possibly even your current or former employer. They may ask your doctor for more detailed information about your abilities to walk, stand, sit, lift, follow instructions and cope with the ordinary stresses of life. You may even be sent to a medical doctor or psychiatrist for a consultative evaluation.

Your own treating doctor’s opinion carries significant weight and is, by law, considered more heavily than any other medical source, but it isn’t your doctor that decides whether or not you are disabled. That decision is left up to the evaluation team that has your case at DDS.

The medical decision comes down to these basic questions:

1. Is your mental or physical condition truly severe and has it lasted (or will it last) at least 12 months? If so, the claim proceeds to the next question.

2. Is your condition on the list of impairments kept by Social Security or does it equal one of those listings? If it does, your claim is approved. If it doesn’t, the claim goes to the next step.

3. Could you return to any of your old jobs? If you could, you aren’t considered disabled. If you can’t, the claim goes to the next step.

4. Could you do some other type of work? The work that’s considered here has to be possible given your age, level of training and education. If you can, you aren’t considered disabled. If you can’t, your disability claim will be approved.

For help with a denied SSD claim, an attorney can be very beneficial.

Source: Social Security Administration, “Disability Benefits,” accessed May 26, 2017

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