The Social Security Administration’s meaning of the word “disabled.”

The Social Security Administration uses the word “disabled” in a different way than some other government agencies and in a different way than you might expect.

What is the definition of “Disability?”

In order to be considered “disabled” so as to be eligible for Social Security benefits, you must offer clear, convincing and objective evidence to the Social Security Administration to prove your disability. You must have a medically determinable, physical or mental health problem (or a combination of problems) severe enough to keep you from working for at least 12 months. The Social Security Administrative will consider you age, education, and past relevant work when deciding whether you should be found disabled. The Social Security Administration currently uses a five step process to determine disability. The test is not whether or not you are able to go back to your old job, or whether you can find a job. Rather, the test is whether considering your age, education and past relevant work experience, there are significant numbers of jobs in existence in the economy that you could perform despite your impairment and the resulting physical and mental restrictions. If there are jobs that you could perform, even if you don’t know about them or have never done them, then you will not be found disabled.

The following are some frequently asked questions about the requirements for qualifying as disabled for purposes of Social Security disability benefits.

Does being disabled for purposes of Workers’ Compensation or VA Disability qualify me for Social Security Disability benefits?

Not necessarily. Agencies such as the Veteran’s Administration and various state workers compensation programs define disability in different ways. The Social Security Administration will make its own determination of whether or not you are disabled, using its own rules and regulations.

A decision by any governmental agency about whether you are disabled is not binding on Social Security. See 20 C.F.R. § 404.1504. While the decisions of other agencies as to disability will not automatically qualify you for Social Security, such determinations are highly relevant and must be considered by SSA. For example, Atkins & Associates, Attorneys-at-Law, recently litigated a disability case where we argued that the Administrative Law Judge (ALJ) erred in denying Social Security benefits to a Veteran because the decision failed to discuss, consider, or mention the disability determinations by the Veterans Administration. We contended that the VA disability finding should have been given great weight and was highly relevant. The Court ruled in our favor finding that the ALJ erred by failing to consider the VA disability determinations and was required to consider the VA disability ratings and given these determinations great weight or explain why they were not entitled to great weight. Click here if you would like to read the entire court decision in Jamiah v. Astrue, 2010 WL 1997886, 152 Soc.Sec.Rep.Serv. 490 (N.D.Ga., May 17, 2010).

What does the Social Security Administration mean by “disabled”?

The Social Security Administration focuses on your ability to work, and defines disability as an inability to work. The exact language of the rule is that “disability” is an inability “to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment.”

Do I have to be permanently disabled?

No. The requirement is that your disability has lasted or is expected to last for at least a year, or expected to result in death.

Who decides whether or not my disability qualifies me for Social Security Disability benefits?

The person who decides changes depending on where you are in the process. When you file your Social Security disability claim, the Social Security Administration sends it to a Georgia agency for an initial determination. That agency gives the case to a disability examiner who works with a doctor to make the initial decision. If that examiner denies your claim and you ask for reconsideration, then a different examiner at the Georgia agency reviews it. If your claim is again denied on reconsideration, you can appeal, and the appeal goes to an Administrative Law Judge who works for the Social Security Administration. After the hearing level, the ALJ decision is reviewed by an Administrative Appeal body called the Appeals Counsel. Thereafter, your claim may be appealed to a Federal District Court.

What are the chances of success for most Social Security Disability claims?

Most Social Security disability claims are not granted at the first filing stage. Approximately 65% of applications are initially denied. Reports of the Congressionally-created Social Security Advisory Board (SSAB) document that initial claim allowance rates are lower in Georgia between 1980 and 2004 than almost every other state, and the hearing allowance rate was lower than 15 other states. See at 59 and 74. The odds at the reconsideration stage are even worse because approximately 85% of claims that are reconsidered are denied again. However, the success rate on appeals is much better because approximately 60% of claims that are appealed are granted.