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SSDI does it take more than a diagnosis?

Many disability applicants have no idea what it will take to win Social Security Disability Insurance (SSDI). Recently on our disability forum we had a user ask, “If I have a diagnosis will this be sufficient to win SSDI benefits, and if not, what else will I need to be approved?”


Diagnosis a great place to start


Talking to disability applicants it’s not unusual for them to believe that once they have a diagnosis from their doctor they will be immediately approved for SSDI benefits. While having a medical diagnosis is a great place to start, it will not be enough to get SSDI benefits.

Assuming you meet the nonmedical requirements for SSDI, the SSA will first determine whether you have a diagnosis listed in your medical records, but they will also look to see if you are suffering from symptoms which make the impairment so severe you cannot work.

Consider, the diagnosis does satisfy the medically determinable requirement in a Social Security disability claim, but it does not prove you do not have the ability to work. For instance, how does your diagnosis affect your functional ability to perform basic work tasks?

Get evidence to prove you do not have the ability to work


Because many claimants believe a diagnosis is all they need to win SSDI benefits they often do not get evidence establishing their functional limitations. A medical diagnosis alone does not establish any functional limitations. More often than not a claimant’s medical records simply outline the doctor’s treatment plan and track the patient’s medical care and do not provide information about what the claimant can and cannot do.

Have my diagnosis what’s the next step?


If you have a clear diagnosis the first step is to review the SSA Listing of Impairments to determine if your condition is listed. If it is, review the corresponding symptoms. If you are experiencing similar symptoms then you may need to review your medical records and make sure the symptoms of your condition are listed.

Next, talk to your doctor. While you do not need a doctor’s note to win SSDI benefits it does help to have a doctor who understands your condition and who is willing to help make sure the right medical information is in your medical file.

If your diagnosis is not listed in the SSA Listing of Impairments then your medical records must have clear information about your functional ability to work. If your condition does not “meet or exceed” a listing the SSA will use your medical records to evaluate if you have the ability to work your current job, past work or retrain for new work.

What if I do not have a diagnosis?


Winning SSDI benefits without a diagnosis is very difficult, especially if you have not gotten proper medical care. It is likely if you have not seen a doctor and you do not have a diagnosis that the SSA could argue that with proper medical care you might be able to work.
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