For those who aren't aware of how the federal disability benefit process works (and to some extent this includes even individuals who have filed for disability, been denied, and had to appeal, as the social security administration does not do a good idea of explaining the overall process to claimants), it basically works like this: An individual who wishes to file for disability will typically contact their local social security office and request that a disability application be taken.
Sometime later, that individual will be interviewed for a claim, either at a local social security office, or over the phone if physically getting to a social security office is problematic.
The purpose of the interview, of course, is to provide information that is needed to process a claim. And this includes providing the claimant's work history, stating which impairments they have, and why these impairments render them disabled, as well as providing a list of their medical treatment sources.
Once the claim has been taken at a social security office by a CR, which stands for claims representative, it is then forwarded to a state disability processing agency. This agency goes by different names in different states, but in most states the agency is designated as DDS, or disability determination services.
However, regardless of the name of the agency or the state in which it is located, the functions performed by this agency are always the same. After a case arrives at the state agency, it is assigned to a disability examiner whose job it will be to gather the claimant's medical records. Once these have been received, the examiner will evaluate them to determine whether or not the claimant's medical history indicates that physical and/or mental limitations exist to the extent that the claimant is no longer functionally capable of engaging in what the social security administration refers to as "substantial gainful work activity".
In some cases, the claimant will have a condition that is listed in the blue book (the impairment listing manual, titled "Disability Evaluation Under Social Security"). And if they meet or equal the approval criteria for that condition, they may possibly be approved for benefits.
However, not every condition is listed in the book, and often the criteria is difficult to satisfy. For the majority of individuals who apply for disability, getting approved for benefits will mean receiving what is known as a medical vocational allowance.
A medical vocational allowance is given when the determination has been made that a claimant has functional limitations (physical, mental, or both) that prevent them from engaging in substantial gainful work activity, either at one of their former jobs (known as "past work"), or at some other type of other work for which they might otherwise be expected to transition to based on their age, education, work skills, and current limitations (not surprisingly, known as "other work").
If it is determined that a claimant cannot return to their past work, and cannot perform some type of other work, they will ordinarily be approved for disability. If the determination, however, is made that they can still perform their past work, or if it is determined that they are unable to perform their past work but can still transition to some type of other work, their claim will be denied.
This is essentially how the disability evaluation process works at the initial claim level for social security disability and SSI disability cases.
Tim Moore
mooreorlesstim3@yahoo.com
http://www.disabilityblogger.blogspot.com
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