Every year, a majority of Social Security disability applicants are denied. In 30% of medical denials, the rejection comes because the Social Security Administration (SSA) finds that the applicant doesn’t meet a medical listing and is still capable of working.
While the applicant might be unable to return to a previous job, if the SSA decides he or she could hold a job somewhere else in the country, then he will not receive benefits. So how does the SSA determine a person’s ability to work? The SSA asks the questions below. Understanding these questions and how the SSA answers them will help you be aware of the details that will assist you in winning your claim.
1. What is your level of activity?
An SSA claims worker will first establish what work you can probably do, or your “level of activity.” This is based on how long you can stand, how much you can lift, how well you can follow instructions, etc. Levels of activity can fall into one of five categories ranging from heavy work to sedentary.
Your claim reviewer will evaluate your level of activity using a residual functional capacity form (RFC). The RFC is a document based on your disability application and medical evidence. The form asks about your ability to do different tasks. Other limitations not included in the RFC may be considered as well. If you have both physical and mental medical issues, then the claim reviewer will likely produce two versions of your RFC.
How can I make sure the SSA correctly understands my level of activity?
Have your doctor fill out an RCF to strengthen your case. Usually a claim worker develops an RFC for you, but having your treating physician’s opinion will mean a lot more in the claims process, especially if you end up going to a hearing before an administrative law judge. All you have to do is print off a copy of the RFC, bring it to your doctor to fill out, and then submit it with the rest of your paperwork. (You might have to pay you doctor a fee for this.) An RFC from your doctor is much more likely to be in your favor than one developed by a claim reviewer.
In determining your level of activity, the SSA will also look at your age and education. The more information you provide to the SSA, the better they will understand your profile.
2. With your current activity level, could you return to a previous job?
After determining your level of activity, the SSA claim reviewer will decide if you could return to a previous job by looking at the past 15 years of your work history.
If the activity level of a previous job is of equal or less intensity than what you are capable of, then the SSA will expect you to return to that job.
If the activity level of previous jobs is greater than that which you are capable of, then the reviewer will move on to the next step: determining if there is a different job you could successfully do with your limitations.
3. If not, could you hold another job?
The SSA determines if there exists a different job you could feasibly do with your limitations, depending not just on your activity level but how much education and work experience you have and how transferrable your skills are. Then, using the “medical-vocational grid rules,” the SSA will use a grid they’ve created which shows the combinations of circumstances that would deem you disabled or not. If they decide (using the grid) that you are disabled, you will receive benefits. If not, and you think the SSA made a mistake, then appeal your case, just be sure to hire a lawyer.
Photo courtesy of Dominik Golenia