When you file an
Application for Social Security Disability or SSI, a local
Social Security employee gathers information from you or
your attorney to determine whether you meet the income and
contribution requirements for benefits. I usually prefer to
gather all of the necessary information and work with the my
client to file an application online so they do not have to
spend hours waiting at their local Social Security
Administration Office. We will need to provide information
to verify your identity, age, quarters/credits of coverage,
whether you are working and how much income you are earning,
the exact date that your disability began and a brief
outline of the medical conditions that your claim is based
Your application and the
information that supports your claim is then assigned to a
claims examiner at the
Louisiana Office of Disability
Determination Services (DDS),
who determines whether you meet the Social Security
Administration's medical and vocational requirements for
The claims examiner at DDS
will attempt to gather medical information from all doctors,
hospitals and clinics where received treatment. While you
might think this would be a fairly simple and rapid process,
three problems often arise.
- First, claimants often fail to tell Social Security
about all of their relevant medical treatment. At the
time of the interview, many people do not remember their
entire medical history or don't know the exact dates and
types of treatment they received. One of the things that
our office focuses upon is making certain that we have a
complete record of any medical treatment that may
support your claim.
- Secondly, some offices and hospitals just do not
respond when DDS mails them a request for medical
records. The DDS claims examiner will send a second
request, but the system's time constraints allow only
limited follow-up. Unfortunately, it's very common for
DDS to deny Disability and SSI applications simply
because they never received the records that prove the
claimant's medical condition.
- Finally, a claimant's medical condition may change
over time or an important medical test may not be
performed until after DDS has received the records from
the healthcare providers. Thus, it is very important to
keep the claims examiner up to date on any changes in
your condition or new tests ordered by your doctors.
More medical information
may be needed before DDS can decide you claim. If the
information is not available from the your current doctors,
DDS may ask you to go to a special examination, called a
"consultative examination," that is paid for by the Social
Security Administration (SSA).
DDS will also usually want
detailed written documentation about your lifestyle and
- Your "activities of daily living," i.e., a
description of the things that you can do on a typical
- Information about your "residual functional
capacity" to sit, stand and walk for specific lengths of
time, as well as your ability to concentrate on, and
responsibility for, and
your relationship with, people who live with you.
- Detailed information
about your education and work experience.
DDS will consider the
written answers to these questions provided by your attorney
along with the medical information provided by your doctors
when they decide whether you qualify for Disability or SSI.
At each step in the
disability determination process, Disability Determinations
Services and the Social Security Administration use a series
of five questions to determine if you are disabled,
Are You Currently Working?
If you earned more than
$980.00 per month from employment
you will usually not be considered disabled. Current income
of less than $980.00 per month is not necessarily considered
to be "substantial gainful activity" and therefore may
disqualify you from receiving Disability benefits. The
current substantial gainful activity income limit for people
who are blind is is $1,640.00 for people who are blind.
Is Your Condition Severe?
Your condition must be
significant enough to prohibit or substantially
interfere with your performance of basic work-related
Do you have an impairment that meets or equals an
impairment described in the Listing
Social Security law
contains a list of impairments for 14 major body
systems. A severe impairments to any of these systems
should result in a determination that you are disabled.
If the condition is not on the list of impairments, DDS
should try to determine if the claimant's medical
condition equals the severity of a listed impairment. If
so, the person is found disabled. If not, the DDS
examiner moves on to the next step
Can You Do The Work You Did Before?
If your condition is
severe, but isn't in the Listing of Impairments, DDS
will then consider whether you are capable of returning
to any of the types of jobs that you had in the last
Can You Do Any Other Type Of Work?
Finally, to determine
if a claimant is able to do other work, Disability
Determination Services considers the person's medical
conditions, age, education, training, work experience
and transferable skills. If DDS decides the person
cannot do other work, the claim will be approved. If the
DDS examiner decides that the person can do other work,
the claim will be denied.
Many people are repeatedly
denied Disability benefits though they appear to meet the
medical and legal requirements. All sorts of factors,
including your age, education and work experience, can
influence the outcome of your claim.
But all too often, the
most important factor is that some people prove their case
with convincing evidence, while other people just leave it
up to the Social Security Administration to develop and
decide their claim for them.
If you are disabled, it is
a mistake to depend upon the Social Security Administration
to develop and decide your claim. The Social Security system
is dramatically understaffed and overburdened. Many claims,
even those involving complex medical and legal issues,
receive only brief consideration.
It is often not enough to
provide the documentation that proves your medical
condition. You will also need to explain how your medical
circumstances meet the legal standards for disability.
Don't leave your benefits
and the funding for your medical treatment up to chance. Get
an experienced attorney on your side to help you win your
Hearings & Appeals