Disability claimWhen it comes to applying for Social Security Disability benefits, the proof you submit in support of your disability claim is crucial to the success of that claim. Your treating physician’s opinions and the contents of your medical records can have a huge effect on whether your disability claim will be accepted. This blog will explain how disability decisions are made and when a person will be considered disabled for purposes of Social Security Disability benefits.

How is “Total Disability” Defined?

Under the Social Security Administration’s rules, you are disabled “if you cannot do work that you did before and we decide that you cannot adjust to other work because of your medical condition(s).” It is expected that your disability is either long-term (lasting for at least one year) or result in death.

Who is Responsible for Determining Disability?

The purpose of Social Security Disability benefits is to provide replacement income for those who are unable to work because of a long-term injury or illness.  You may be surprised to know that it is not actually the Social Security Administration that is responsible for making the decision regarding disability claims.
Instead, when your disability application is submitted, the file will be sent to the designated state office for review of your medical records and any other medical evidence you submit with your claim.  This office has a different name in each state.  In Arkansas, it is called Arkansas’s Disability Determination for Social Security Administration. In Missouri, it is called the Missouri Disability Determination Services.

When Is a Person Considered Disabled?

Social Security analysts typically expect to see at least a 12-month medical history, relating to the applicant’s condition for which disability is being claimed.  This medical information should be “current,” meaning records of medical treatment received within the last 90 days.
However, in many cases, applicants have run out of money or insurance to pay for treatment, making current medical information hard to obtain.  Unfortunately, many individuals applying for social security disability are already financially strained because they have been unable to work due to their medical condition.

How Will My Disability Claim Be Processed?

Most Social Security disability claims are processed through the local Social Security Administration field offices.  This means, your state’s social security agency will determine your medical eligibility for disability benefits. The process for making this determination has been standardized throughout the United States.  This means that each analyst in each state will utilize the same questions in determining whether a claimant meets the disability standards.
If you appeal an unfavorable determination, it will be decided either by a Disability Determination Services agency or by an administrative law judge in the Social Security Administration Office of Disability Adjudication and Review.

Why Are So Many Disability Claims Denied?

The most common reason that Social Security disability applications are denied is lack of sufficient medical evidence.  In many cases, applicants need to submit to a consultative examination, during the application process.  This extra step is most often required when an applicant either has no medical evidence or the evidence they had submitted is too old to be considered.

The Need for a Residual Functional Capacity Assessment

Except for very limited situations where approval of a disability claim is automatic, you will be required to submit a Residual Functional Capacity assessment. This assessment must be prepared by your treating physician. The only exception is in cases where your disability is included in the Social Security impairment listing. The purpose of the assessment is to establish what the claimant is still capable of doing despite the claimed disability.
The Residual Functional Capacity assessment is a detailed report from your treating physician describing any limitations you have as a result of your medical condition.  The assessment also specifies how your limitations affect your ability to do certain work-related activities. The problem is, there are some physicians who are unwilling to complete the assessment form, which presents a challenge in proving your disability claim.

Helping Your Physician Understand What Is Needed

If your physician does not know what to expect or what is expected of them, you can help by assuring her that all that is required is completing the form. The opinion she gives to the agency will not affect her practice or threaten her license. Once the form is submitted, that is typically all that is required of your physician. If your physician believes that completing the form will be far too time-consuming, showing him the Residual Functional Capacity assessment form might help.  The required information can usually be obtained during a regular appointment since the physician is already familiar with your condition.
If you have questions regarding disability claims or any other Social Security Disability matters in Arkansas or Missouri, please contact the Cottrell Law Office for a free consultation. You can contact us either online or by calling us toll-free at (888) 616-6356.

Author Photo

Wesley Cottrell

Wes Cottrell earned his B.A. from Pittsburg State University in 1981 and his J.D. from the Washburn University School of Law in Topeka, Kansas in 1985. He was admitted to practice law in Kansas in 1986, in Missouri in 1987, in Arkansas in 1989, and Oklahoma in 1993. He is licensed to practice law in the United States District Court for the District of Kansas, eastern Arkansas, western Arkansas, and western Missouri. He was Deputy Prosecuting Attorney in Crawford County, Kansas from 1987-1989.

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