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How does SSA evaluate a claim for disability benefits?

To residents in Missouri and elsewhere, the evaluation of a claim for Social Security Disability Insurance or SSDI benefits often appears to be an opaque process performed behind closed doors by anonymous bureaucrats. In fact, the process for evaluating an SSDI application is guided by explicit standards that must be followed by all SSA employees who are involved in assessing SSD claims.

The process comprises two separate inquiries. First, is the applicant prevented by an injury or illness from working, and second, does the applicant satisfy the non-medical eligibility requirements? The non-medical eligibility requirements are evaluated by the field office that receives the application. The information includes age, marital status and Social Security coverage information.

Answers to the first question are governed by the Listing of Impairments, an extensive catalogue of disabling illnesses and injuries that are eligible for benefits. The Listing is published in the Code of Federal Regulations and online. If an applicant's illness or injury is on the Listing of Impairments, the application is usually granted.

If the applicant's medical condition or level of disability is not covered explicitly by the Listing of Impairments, the application is first reviewed by a Disability Determination Service or DDS; a DDS is usually an agency of the state where the applicant resides. The DDS first seeks information from the applicant's medical providers. If that information is insufficient or unavailable, the DDS will arrange a consultative examination. After assembling all available information, the DDS makes an initial decision to approve or reject the application, and the applicant is notified in writing.

Anyone contemplating filing a claim for disability benefits or who has had a claim denied may wish to consult a lawyer who specializes in handling SSDI claims. A knowledgeable attorney can provide advice about the information necessary to support the application and can assist in filing an appeal if a claim has been denied.

Source: Social Security Administration, "Disability Evaluation Under Social Security," accessed on July 31, 2016

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