What Social Security Does Not Consider When Evaluating a Claim
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There are a lot of articles written about what factors Social Security considers when deciding a disability claim. Much less is said, however about what factors Social Security will not consider in making its determination. If you want to win your case, it is just as important to understand these much less discussed factors. Below are several examples.
1. I am able to work but cannot find a job in my area
Social Security only considers whether your impairments prevent you from being able to work. Social Security evaluates your ability to perform the physical and mental activities of your past work and whether you could perform other work based on your age, education, and past work experience. The agency does not consider the economy or whether you are able to actually get hired for the job.
Social Security does not consider the following factors when determining whether you are eligible for benefits:
- whether you would be hired
- whether a job opening exists
- whether you would be required to move
- whether you want to do this work
- whether you still have a certificate or license to do the past work, or
- whether you have transportation issues.
However, if Social Security says there are jobs you can do, there must be sufficient numbers of these jobs, not just a few jobs in a few areas of the country. For more information, see our article on challenging the number of jobs available.
2. My doctor has written a letter that says I am disabled
Being "disabled" can mean many different things to many different people. As a result, Social Security regulations specify that they must determine whether you are “disabled” according to the official definition. Social Security will not consider your doctor’s statements that you are "disabled." The agency will consider your doctor’s opinion regarding your functional limitations, that is, how long you can stand, sit, or walk, and whether you are able to concentrate, interact with others, or perform activities of daily living. These functional assessments can be critical to winning a Social Security case. An experienced attorney will be able to provide your doctor with a form to document your specific limitations, or you can give your doctor our RFC form.
3. I have symptoms of pain and fatigue, but no diagnosis
In order to be found disabled, you must have a "medically determinable impairment." A medically determinable impairment must established by medical evidence, including signs, symptoms, and laboratory findings. Your statements of fatigue and pain are not sufficient to prove your case. They must be reasonably be caused by an impairment that has been documented by a physician according to acceptable techniques. For more information, here are some common complaints that Social Security sees on disability applications where Social Security may try to argue there is no medically determinable impairment:
- chronic pain
- back pain
- carpal tunnel syndrome
- chronic fatigue, and
- reflex sympathetic dystrophy.
4. I am partially disabled
To qualify for Social Security benefits, you must be unable to do substantial work for at least one year. Generally, Social Security defines substantial work as being able to make $1,090 or more per month. (See our section on substantially gainful work for more information.)
Unlike workers' compensation or Veterans Administration benefits, individuals do not receive a disability rating and there is no partial disability. Either you meet Social Security's definition of disability or you do not. Put another way, there are no partial benefits. Disabled individuals receive their full benefit amount or are not entitled to a benefit. (SSI is an exception to this rule; SSI payments can be lowered if the recipient has other income.)
For more factors that Social Security won't consider, see our article on what not to say to a disability judge.