My doctor said I was disabled, why was I denied by the SSA?Many doctors have provided documentation to Social Security Disability (SSDI) or Supplemental Security Income (SSI) claimants, which states they are disabled and unable to work. Claimants may mistakenly believe that a doctors note will be enough to win either Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). So if a doctors note is not sufficient to win disability benefits what do you need to prove you are disabled?
First, you need to understand how the SSA makes their disability determination for both SSI and SSDI.
Sequential Evaluation and Determining Disability
The Social Security Administration uses what they call the Sequential Evaluation process to evaluate whether a claimant is disabled. The SSA sequential evaluation process is a series of five questions:
1. Are you working?
If you are working and earning more than $1,000 a month in 2011 the SSA believes that you are productive and will deny benefits.
If you are not engaged in substantial gainful activity the Social Security Administration proceeds to the next step.
2. Is your disability or condition "severe"?
The Social Security Administration wants to know whether your condition is severe and whether it interferes with your work. If they do not believe it is severe, they will deny your disability claim. If they do believe it is severe, they will proceed to step 3.
3. Is your condition found in the SSA Listing of Impairments?
Many claimants want to know what conditions the SSA consider automatically disabling. The Social Security Administration has listed the disabilities, diseases or conditions that they have determined automatically disabling in their Listing of Impairments or more informally the Blue Book. If your condition meets a listing, which means your condition matches a listing or is as severe as a listed condition, the SSA will find you disabled. If not, they will proceed to step 4.
4. Can you do the work you did previously?
Many claimants do not have a condition that meets a listing so the SSA will continue to evaluate whether they have the residual functional capacity to work. If the SSA finds that a claimant cannot do their previous work they will proceed to step 5. If they can, the SSA will determine they are not disabled.
5. Can you do any other type of work?
If a claimant cannot perform their previous work they will evaluate if they can work any previous job or a job they could be retrained to perform given their medical conditions, age, work history, education, and work skills.
If they determine the claimant cannot work a previous job or retrain for new work they will approve the disability claim. If the SSA believes they could perform past work or retrain for new employment they will deny disability benefits. If they do not believe the claimant could work their previous job or retrain for new work they will award disability benefits (this is an approval through a medical vocational allowance).
What does the SSA consider as evidence for a Disability?
So if a doctors note is not necessarily enough to prove disability, what type of evidence does the SSA need to make their disability decision? The SSA will evaluate all of the medical evidence in a claimants medical files (doctor's notes but laboratory findings, X-rays, MRI, physical therapy notes, blood tests, etc.). Keep in mind, the SSA will only consider evidence from valid medical sources including:
licensed medical or osteopathic doctors
licensed or certified psychologists
qualified speech-language pathologists only for purposes of establishing speech or language impairments
licensed optometrists only for purposes of establishing visual disorders (except in the U.S. Virgin Islands where licensed optometrists are acceptable medical sources only for the measurement of visual acuity and visual fields)
licensed podiatrists only for purposes of establishing impairments of the foot
What if your Doctor does not Support your Disability Claim?
What if your doctor does not support your claim for disability? It may not matter, but there are two issues when a doctor does not support a claim: 1) does he think you are disabled but does not want to get involved with the disability process; or 2) does he think you are not disabled and has stated this in your medical records.
If your doctor states you are not disabled in your medical file, this could hurt your disability claim. If your doctor simply is too busy or does not want to get bogged down in the disability process but supports your claim, this may not hurt your chances to win either SSDI or SSI.
Hiring a Social Security Disability Lawyer
If you would like a Social Security Disability attorney to review your Social Security Disability Insurance or Supplemental Security income claim you can fill out the FREE evaluation form and a disability advocate will call you to review your claim or you can call our office at 1-800-641-3759 to talk to someone now.