Friday, September 30, 2011

Medical Records and More: What SSA Uses to Make a Decision on Your Claim

One misconception commonly held by those applying for disability benefits in San Francisco is that the only important aspect that factors into the determination process are supportive medical records. While it is true that the main requirement for qualifying for disability benefits is determined by relevant medical records, past work experience also factors heavily into Social Security’s determination process. If a claimant is found to be able to return to a past job, he or she will be denied on the basis that the disability is not severe enough to keep the claimant from working.

Social Security first determines the claimant’s residual functional capacity in order to compare it to past relevant work. There are four different levels to classify residual functional capacity:

  • Sedentary: the claimant is able to sit for six hours, stand or walk for two hours and lift a maximum of 10 pounds
  • Light: the claimant is able to sit for six hours, stand or walk for six hours and lift a maximum of 20 pounds
  • Medium: the claimant is able to sit for six hours, stand or walk for six hours and lift a maximum of 50 pounds
  • Heavy: the claimant is able to sit for six hours, stand or walk for six hours and lift a maximum of 100 pounds

If the residual functional capacity of the claimant prevents the return to previous work, the examiner will also look at the claimant’s skill level of previous work, education and age to determine if the claimant can return to work. Skill level is separated into three levels: unskilled, semi-skilled and skilled work. Education levels range between illiterate and high school graduate or more. If a claimant has below a high school education, Social Security will consider the fact that the education level of the claimant does not have direct entry into skilled work. For those with an education level of a high school graduate or above, Social Security will take into consideration that the claimant’s education level provides direct entry into skilled labor.

Similarly, age is taken into account when Social Security examines the claim. Claimants 49 and younger are classified as “ Younger Individuals,” and will find that Social Security has stricter rules when determining their disability. When a claimant reaches 50, the rules to determine their disability and ability to return to work are relaxed. Similarly restrictions are loosened again at 55 and 60. While supportive medical records play the most important role in Social Security’s determination process, past relevant work, education and age also weigh heavily in the determination process.

The best way to ensure that your claim is handled properly is to hire an attorney. Your disability attorney will stay on top of all paperwork and requests from Social Security and make sure that all your medical records have been received. For more information, visit us at www.socialsecuritylaw.com.

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