How Does the Social Security Administration Decide if I Medically Qualify for Disability?

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The determination that an applicant for Social Security Disability is "disabled" is based on the findings of an investigation conducted by the Social Security Administration and the Florida Department of Health, Disability Determination Services. The investigation is a five-step process used to determine whether a person is disabled for the purpose of Social Security Disability Insurance ("SSDI") and Supplemental Security Income ("SSI"):

  1. Is the Applicant Currently Working?
    If the applicant is currently working (or has worked after the date they claimed their medical condition(s) began to affect their ability to work) and earning over a certain amount of money, then by rule the applicant is not disabled. If the applicant in the Panama City area is making below the certain amount, then the Social Security Administration will forward the claim to the Florida Department of Health Disability Determination Services ("DDS") in Tallahassee or Pensacola for a review of the applicant's medical conditions. The amount an applicant can make while still qualifying for Social Security Disability is occasionally adjusted by the Social Security Administration. For the current amount an applicant can make and still qualify click here.
  2. Is the Applicant's Medical Condition Severe?
    To be disabled DDS must make the determination that the applicant's medical condition significantly limits their ability to work for at least one year. If the applicant's medical condition is not considered severe by DDS, then the applicant will be denied benefits by the Social Security Administration. DDS will take into consideration the effect of the medical condition on the applicant's ability to work. DDS will consider issues like the applicant's ability to do basic work activities including walking, sitting, concentrating, and remembering instructions.
  3. Is Applicant's Medical Condition on the List of Impairments?
    The Social Security Administration has compiled a List of Impairments (i.e. medical conditions) that are so severe that an applicant diagnosed with one of these conditions is automatically disabled by law (i.e. they "meet a listing"). If the applicant's medical condition is not on the List of Impairments then DDS will make a determination of whether the applicant's condition (or combination of medical conditions) is so severe that it meets or equals a medical condition on the List of Impairments.
  4. Does the Applicant's Medical Condition Prevent them From Working at Any of the Jobs They Have Had in the Past?
    DDS will make a determination of whether the applicant is able to do any of the jobs that the applicant has had in the 15 years prior to the claimed onset date of their disability ("past work"). To qualify for Social Security Disability, DDS must determine that the applicant's medical condition(s) prevents them from doing any "past work".
  5. Can the Applicant Do Any Other Type of Work?
    Once a determination has been made that an applicant cannot do any of their past work, DDS looks to see if there is any other work that exists in significant numbers in the national economy that the applicant can do. In making this evaluation, DDS looks at factors such as the applicant's medical condition(s), age, education, past work experience, and any skills from past jobs that may be used to do other work ("transferrable"). It is important to understand that the job that DDS suggests that the applicant may be able to do, does not necessarily mean that the suggested job is available in the Panama City area. Further, even if the job is available in the Panama City area, a disability determination is not based on the applicant's ability to be hired to do the job by the employer. It only means that a job exists in the national economy.

If you are thinking about applying for Social Security Disability, or have already applied and have been denied, contact The Disability Group today for a free consultation and case evaluation. Ms. Gunter and the team of dedicated paralegals have helped hundreds of clients get the disability benefits they deserve and they have knowledge and experience in navigating the Social Security Disability appeal process.

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