Social Security has a strict definition of disability. That definition is “inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” That is all well and good, but actual people are the ones who determine whether a claimant is disabled and those people could be examiners at a state agency or an Administrative Law Judge (ALJ). Below is an explanation of who makes a disability determination at different stages of the process.
We’ll review your application to make sure you meet some basic requirements for disability benefits. We’ll check whether you worked enough years to qualify. Also, we’ll evaluate any current work activities. If you meet these requirements, we’ll process your application and forward your case to the Disability Determination Services office in your state.
This state agency completes the initial disability determination decision for us. Doctors and disability specialists in the state agency ask your doctors for information about your condition. They’ll consider all the facts in your case. They’ll use the medical evidence from your doctors, hospitals, clinics, or institutions where you’ve been treated and all other information. They’ll ask your doctors about:
- Your medical condition(s).
- When your medical condition(s) began.
- How your medical condition(s) limit your activities.
- Medical tests results.
- What treatment you’ve received.
They’ll also ask the doctors for information about your ability to do work-related activities, such as walking, sitting, lifting, carrying, and remembering instructions. Your doctors don’t decide if you’re disabled.
The state agency staff may need more medical information before they can decide if you’re disabled. If your medical sources can’t provide needed information, the state agency may ask you to go for a special examination. We prefer to ask your own doctor, but sometimes the exam may have to be done by someone else. Social Security will pay for the exam and for some of the related travel costs.
