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What is A Disabling Health Condition?

The Social Security Administration may consider any health condition to be disabling if it is expected to last at least 12 months or more or may result in the individual’s death. The mental or physical health condition also must be so severe that it prevents an individual from performing “substantial gainful activity” which the Social Security Administration considers as making more than $1,000 per month in 2010 or working a regular 40 hour per week work schedule (or the equivalent work schedule).

While any condition which severely limits a claimant to the extent that they can not perform any job at a level to be considered gainful and substantial can be considered disabling, the Social Security Administration does have standards which are referred to as The Listing of Impairments which they use to evaluate a claimant’s disabling health condition.

The Listing of Impairments specifically describes common medical conditions the Social Security Administration automatically considers disabling. Claimants who “meet the listing” or have a condition which is specifically outlined in the Listing of Impairments (with the same limitations and symptoms) will frequently receive Social Security Disability Insurance or Supplemental Security Income benefits at the initial application level. If an applicant does not meet a listing the Social Security Administration evaluates the severity of the condition, if the physical or medical health condition limits the individual’s ability to work and if the condition leaves any residual functional capacity (RFC) for the claimant to continue working.

Residual functional capacity or RFC is the amount of activity an individual can perform in spite of their physical or mental health conditions. Standard physical residual functional capacity can include the claimant’s ability to stand, walk, sit, lift, bend or stoop. Mental residual functional capacity can include the claimant’s ability to work well with others, follow directions, get along with co-workers, attend work and maintain standards of cleanliness, pace and concentration.

After the Social Security Disability examiner determines the claimant’s RFC or residual functional capacity they can determine if the claimant can work full-time at any job they have had previously (examiners generally evaluate the claimant’s last 15 years of employment), and if not, if they can be retrained to work in a new job. A claimant’s ability to retrain for a new job is based not only on their RFC but also other factors such as their age, work experience and their educational level. The Social Security Administration may determine a claimant has a disabling health condition if they can not perform any past jobs or their residual functional capacity is so limiting they can not be retrained for any new type of work.

Medical records, doctor’s statements, physical and mental assessments and other documentation may be used by the Social Security Administration to evaluate a claimant’s residual functional capacity. Impairments by themselves may not be completely disabling, but the Social Security Administration will evaluate the combined effects of all listed health conditions when considering a claimant’s RFC.

It is not unusual for claimants to ultimately receive Social Security Disability benefits because both the mental and physical conditions, when considered together, leave the claimant with very little residual functional capacity. Unfortunately, given the subjection nature of evaluating Social Security Disability claims which do not meet a listing, many claims are not awarded benefits until the Hearing level when the Administrative Law Judge is able to truly evaluate the claimant in person and offer a more subjective conclusion of their ability to continue to work.