What proof does SS need to document disability?

[MsAnnie]

Hi Richard and others,

I am just about ready to lose my job due to cognitive issues. A job that I have done for six years and can no longer manage. I had tests 3 years ago that showed significant issues with short term memory, but now my processing has slowed and my analytical skills are diminished and I can no longer fake it.

My Dr. does not want to retest test ($$$?) and says just apply for disability. What does SS need to document disability? Help!

- Annie

[Rich Feingold]

Hi, Annie. Sorry to you and everyone for the tardy reply. SSA has a five step sequential process for determining disability. I talk about the five step process on my website, www.usadisabilitylaw.com:

The 5-Step Process:

The Social Security Administration uses a five step process for determining whether or not adults are disabled:

Step 1 – Are you involved in Substantial Gainful Activity (SGA)? If yes, you are not disabled.
If no, proceed to Step 2.

Step 2 – Do you have a “severe” impairment, one that at least minimally affects your ability to work? If no, you are not disabled. If yes, proceed to Step 3.

Step 3 – Does your impairment meet or equal one or more of Social Security’s “Listings of Impairments” – medical criteria that presumptively prove that you are disabled? If yes, you are disabled. If no, proceed to Step 4.

Step 4 - Are you able to perform past relevant work given your Residual Functional Capacity (RFC)? RFC means what you still can do given the limiting effects of all of your physical and mental impairments. Past relevant work” means work that you have performed in the past fifteen (15) years. If you are unable to perform your past relevant work, then the Social Security Administration must prove Step 5 in order to deny you benefits.

Step 5 - Can you perform any other jobs given your age, education, past work experience and Residual Functional Capacity (RFC)? If you can perform any other jobs given all of the laws applying to Social Security disability claims, then you are not disabled. If you are unable to perform your past relevant work, or any other work, then you will be found disabled.


At step 3, to meet the MS Listing, one must show:

11.09 Multiple sclerosis. With:

A. Disorganization of motor function as described in 11.04B; or

B. Visual or mental impairment as described under the criteria in 2.02, 2.03, 2.04, or 12.02; or

C. Significant, reproducible fatigue of motor function with substantial muscle weakness on repetitive activity, demonstrated on physical examination, resulting from neurological dysfunction in areas of the central nervous system known to be pathologically involved by the multiple sclerosis process.


But if one does not meet the Listing, then one can prove disability if one cannot perform one's past relevant work (Step 4) (work performed in the past 15 years) or any other work (Step 5) given one's residual functional capacity, age, education and past work history.

So you see, Annie, the determination of disability depends upon a number of factors. The basics include consistent treatment with a neurologist who backs up your claim as well as medical records which consistently document credible symptoms. It is a good idea to speak with an attorney who practices in this area of law concerning your own possible claim.

Rich

[Cate Power]

For you or anyone else reading who truly cannot work in your prior or any other job, the best route to getting on the rolls is to submit medical evidence that proves you meet the listing for a presumptively disabling impairment. If one has evidence to satisfy the MS listing, the process should be relatively straightforward, with approval at the State agency level and no need for counsel. Following is a link to the MS listing:
http://www.socialsecurity.gov/disabi...dult.htm#11_09

If you file for benies without evidence satisfying a listing, the review process can be years long and frustrating. Of course, Rich also IDs the steps correctly, you must have a severe impairment expected to last for 12 mos. or more and you can't be engaged in SGA, substantial gainful activity. My point is that it is MUCH better to file when you satisfy step 3, the listings, then to have to try to make it in at steps 4 or 5.

[Rich Feingold]

Cate - I am not sure that claimants have control over whether they will prevail in their claims at Step 3. Also, what "should" happen versus what does happen are two different things. A lawyer can evaluate a claim and know what has to be established to prove disability. For example, some claimants can establish disability even if they can perform some full-time work. Also, an attorney can evaluate the claim in regard to the MS Listing and make legal arguments as to why the claim should be approved. Often, also, claimants are not in a position to represent themselves because of everything else the have to deal with. An attorney would be paid only if the claim is successful and from past due benefits with a fee cap. It is a win-win situation.

Rich