Sunday, January 22, 2012

First Stage of the Disability Claim Process



To apply for disability benefits, the individual must go to the local SSA district office and complete application and medical release forms. The application will include employment history, identification of alleged impairment(s), names and addresses of treating physicians and hospitals, and a description of how the alleged condition keeps the claimant from working. 

After completion of forms, the district office will make a determination as to whether the claimant has paid enough into the trust fund. A computer search will answer this inquiry. Next, the district office sends the claim to the State Disability Determination Service (DDS). The DDS obtains the medical records and then passes them, along with the application, to a physician and an adjudicator. 

The physician will review the medical records and determine how the alleged impairments would affect the performance of mental and physical tasks such as oral and written communication, bending, lifting, walking, etc. The physician's report of findings is submitted to an adjudicator who uses it to determine if any of the claimant's impairments equal or meet the severity of conditions in the Listings. The Listings include thirteen sections of impairments, ranging from ailments of the musculoskeletal system to malignancies. A claimant meeting one or more of the conditions in the Listings is automatically considered to be disabled since medical science has concluded that substantial gainful activity is highly unlikely with these conditions, and the impairments are expected to result in death or last for a continuous period of not less than twelve months. 

If the claimant's condition is not clearly identified in the Listings, the State adjudicator should measure the residual functional capacity of the claimant, ranging from "Very Heavy" to "Less than the Full Range of Sedentary." This determination assumes that disability can be ascertained by establishing an applicant's ability to function despite an impairment.

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