How does the Social Security Administration determine if someone is disabled?

The Social Security Administration social security benefitshas several thousand regulations regarding the proper way to determine whether a person is disabled.  A lot of factors go in to making that determination, but some of the main factors are a person’s age, education and work experience, as well as the extent of documentation that can be obtained regarding a person’s physical and mental condition.  Sometimes, but not always, the Social Security Administration will arrange for physical and/or mental evaluations to get more information about how a person is functioning, mentally or physically.

The Social Security Administration’s definition of disability is somewhat different from the way the term is used in general conversation or in other government or private programs.  The Social Security Administration only pays for total disability.  There are no benefits for partial disability, and no benefits for short term disability.  One either qualifies for benefits based upon total, long term disability, of one does not qualify for any Social Security Disability benefits.

To be meet the Social Security Administration’s definition of disability, the person must be unable to do the work that was done in the past.  The regulations, in general, look back at the work a person has done within the last fifteen years.  Jobs further back in time than that, as a general rule, do not count, because over time, the requirements of a job change, and frequently change quite a bit.      

The regulations also consider whether an individual has the ability to do other work.  This is a part that many people don’t understand when they come to see me.  Even if you can’t do the work you have done in the past, a person does not meet the definition of disability if there are other, full time jobs that the person can still do.  Many private policies of disability insurance pay benefits if a person can no longer do their most recent job.  SSA does not look at it that way, though.  If there are other full time jobs a person can perform, the person does not meet the definition of disability.

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Additionally, the person’s disability must either have lasted, or be expected to last, at least twelve consecutive months, or be expected to result in death.   One can file for disability without waiting for that 12 month period to end, and I generally encourage people to file if their disability is expected to keep them from working full time for at least twelve months.

There are many other provisions relating to SSA’s definition of disability, so each person’s case is unique.  I enjoy figuring out which regulations can help our clients, and getting the information together that proves a person meets the program’s complicated requirements.  My goal is to find a way to help our clients who are genuinely unable to work on a full time basis, by using the various regulations applicable to the specific circumstances of each client’s case.  I would like to speak with you and find out the specifics of your disability and how the disability law regulations can apply in your case. If you would like to set up a consultation to discuss the specifics of your case, please contact me.