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How are claims for SSD benefits evaluated?

Most Missourians know that the process for obtaining Social Security Disability Insurance (SSDI) benefits is run by the Social Security Administration, an agency of the federal government. Unfortunately, the sheer size of the SSA tends to obscure the process that is used to review and approve or deny applications for SSD claims. This post will describe the essential features of that process.

All applications for disability insurance benefits must be filed in writing or on line. The application is first reviewed by an SSA field office to determine if the applicant is financially eligible. The second stage is a review of the applicant's disability. If an application passes steps one and two, the file is next reviewed to determine whether the applicant's mental or physical condition satisfies the SSA's written criteria for disability, called the Listing of Impairments. If an applicant's medical condition satisfies one of the items on the Listing of Impairments, the application is usually approved and benefits are awarded based upon the applicant's financial situation.

Applications that are rejected at step three will receive further review to clarify the applicant's ability to perform the kind of work he or she performed in the past. The applicant will be asked to take a residual functional capacity examination to evaluate the extent of their ability to work in any job. If this review determines that the applicant has no ability to work in any capacity, the application will be approved. If the SSA determines that the applicant can perform the tasks of his or her previous employment, the application with be denied. Applications that are not denied at this point will receive additional screening to determine if the applicant can perform any gainful work. At the end of this review, an application is either finally approved or finally denied. Unsuccessful applicants can ask for reconsideration by the SSA, take an appeal within the SSA or bring an action in federal court.

This summary does not explain all of the various employment and medical requirements that govern the award or denial of disability benefits. Anyone who is contemplating making an application for disability benefits may wish to consult a lawyer who specializes in such cases. A consultation with an experienced lawyer can provide a helpful analysis of the claim and of the likelihood of receiving an award of disability benefits.

Source: Social Security Administration, "Identifying SSA's Sequential Disability Determination Steps Using Administrative Data," accessed on Dec. 28, 2015

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