SSD Disability: What Is a Disability for Social Security?

The Social Security Administration (SSA) determines that a physical or mental impairment is a disability only if it can be demonstrated, through a complete medical and work history, that the impairment is severe enough to prevent you from doing your current job, or any other work to which you may be suited, for at least 12 months.

True, the SSA publishes a book of physical and mental conditions that it recognizes as disabling, commonly referred to as the “blue book,”(it’s blue), but being diagnosed with a condition listed in the blue book does not guarantee that you will be awarded disability benefits. Why? Because the SSA awards benefits, not to those who have any particular impairment, but to those who can prove that, because of their impairment, they are unable to earn enough money to support themselves (and this amount is referred to as SGA, or substantial gainful activitity.

In other words, it’s entirely possible that someone who has had a heart attack will not be awarded disability benefits, while someone with depression will be awarded disability benefits. In either case, it depends on the severity of the condition as demonstrated in the medical records seen by social security. If this seems unfair, keep in mind that one of the criteria that must be met to win social security disability (SSD) or supplemental security income (SSI) benefits is that your condition is both severe and ongoing, and unlikely to improve over the next year.

Of course, regardless of your basis for filing for SSD, you will be awarded nothing unless you have medical documentation to back up your claim. When you first apply to SSA for disability, you should provide a complete medical history, including any medical facilities at which you have received treatment or testing (the first place to treat you for your condition is important in establishing when your symptoms began, or a date of onset), as well as physician names and addresses, and correct contact numbers. You must also provide the names and addresses of any current treating physicians or treatment facilities—without a current treating physician, you cannot prove that you are currently disabled. If, due to lack of funds or medical insurance, you have not seen a doctor recently, try to find a free clinic or a physician who will treat you on a sliding scale (charge only what you can afford). Your county health department should be able to provide you with a list of low-cost health care options in your area.

It’s a lot of work to get all of this medical documentation together, but it’s worth it, because if you don’t supply enough medical evidence to back up your claim, the state disability examiner will most likely order you to attend a consultative exam (CE). A CE is a very brief exam with a doctor (who is not employed by social security but conducts exams on a contract basis), lasting on average about 10 minutes. It’s in your best interest to have your own physician evaluate your medical condition after an in-depth physical examination, for reasons that should be obvious.

A complete work history is just as important to a disability examiner’s decision-making process as a solid medical history.
Remember that without a list of past employment positions and the duties associated with those positions, a disability examiner will have no choice but to guess what you know how to do, or what types of work you have done in the past. Again, it’s in your best interest to spell out your job skills and education, for obvious reasons. Just as with your medical history, be sure to include names, addresses, and correct phone numbers for past places of employment, including contact information for your past supervisors if possible.

Again, this will take some time, but if you win SSD/SSI benefits it is well worth the effort.