How Social Security Officials Evaluate Your Disability Claim

The initial claim is processed at the state Disability Determinations Services (DDS) office. The claim will be assigned to an examiner, who collects the medical data, work information, function reports, and gets opinions from Social Security doctors. The assessment of this data is how they determine whether you fit into Social Security’s definition of disability.

You’re likely not going to have a lot of interaction with the examiner at DDS. They’re doing this assessment sight unseen. This review is heavily focused on your medical condition and documentation that supports your disability claim.

Evaluations At The Hearing Level

If your initial claim and Request for Reconsideration have been denied, your third level of the application process is appealing to the Office of Hearings Operations (OHO). Your case goes in front of an Administrative Law Judge (ALJ), who is trained not only in the legal aspects of disability claims, but in understanding medical impairments as well.

When evaluating your disability case, these judges take the opportunity to hear from the person who’s filing. They hold an informal hearing of about an hour, wherein you have conversations about:

• What has kept you from being able to work.
• What health issues you’re dealing with.
• What those health issues are doing to you on a day-to-day basis.
• And more…

This information helps the judge understand the personal side of the medical documentation so when they go back and read what your doctor had to say, they can think, “Okay, this person explained to me that their back problem is causing him difficulty bending or lifting or standing. Now I understand what they are is saying to the doctor when they are complaining about this issue.”

The judges take sworn testimony from the individual claimant, as well as from a Vocational Expert (VE), who is a job placement professional able to provide details about jobs the person filing for disability benefits has done in the past. The expert also examines:

• What other jobs might use similar skills.
• What those jobs look like physically or mentally.
• Whether the applicant is able to perform work that is:
  • Similar to what they’ve done before.
  • Different, but still within their skill set.

The ALJ may ask hypothetical questions to get a sense of what kinds of jobs may be available with limitations similar to the claimant’s.  These hypotheticals my include limitations found in your medical records or from your testimony.

The Role Of Medical Providers

A successful application for a disability requires all your doctors to release copies of treatment records and, more importantly, provide a clear statement about:

• Your limitations.
• The effect of your injury or disease on your health and your ability to function.
• Why you might not be able to work.

The Effect Of Age, Education, And Work Experience

Regardless of whether you’re 18 or 65, Social Security must consider your age, education, and work experience to help determine whether you’re disabled. For most people, to qualify for disability benefits SSA must determine that you are not able to go out and do any kind of job on a day-to-day basis.

However, as you age, there are some allowances in the program that consider the realities of the workplace. The older you get, the harder it is to make a transition to other types of work. The older you get, the more difficult it becomes to be hired. For people who are over age 50, the evaluation of your work background becomes essential.

SSA assesses whether your job allows for skills that could easily translate into a lighter-duty job, such as a sit-down job, for instance. Do you have the skill set to make that transition without requiring additional training such as additional schooling?

People with a marginal education are given allowances. Regardless of age, if Social Security is assessing a person with an intellectual disability, it makes it easier to connect the limits of the person’s mental capacity to the types of jobs the individual can perform.

However, for a person 50 years or older, Social Security must assess how easily this person, who has either a vocational or educational background, could transition into a job in some other field.

For instance, if you have worked as a nurse, could you rely on your medical training to transition to working as a medical billing clerk or at a front desk in a medical office?

The work experience component certainly plays a significant role in the way that Social Security evaluates people who are over the age of 50. If you’re over 55, Social Security focuses heavily on whether or not your skills can be used in the same industry or the same type of field.

In other words, they’re not going to take you from working in a factory to working in an office environment unless it’s clear that the skills you learned at the factory translate into your working in the office.

With the guidance of a skilled attorney for Social Security Disability Law Cases, you can have the peace of mind that comes with knowing that we’ll make it look easy. For more information on Social Security Disability Law in North Carolina, a free initial consultation is your next best step. Get the information and legal answers you are seeking by calling or texting (704) 412-4773 today.