Determining Disability: How Does the SSA Decide?

While the Social Security Administration (SSA) is a federal agency, the leg work in determining if one is disabled is done at the state level by state workers. They follow the guidelines and procedures set forth by the SSA when determining if an applicant for SSD is disabled. Thus, Michigan SSD applicants will have their applications determined by the Michigan Disability Determination Services workers.

To receive Social Security Disability (SSD) benefits, the applicant must be found to be disabled. Your doctor will be asked for information about your medical condition, but will not make the final determination on disability. SSA notes that the treating doctor(s) will be consulted with and asked for information such as:

  • What the medical condition is
  • When the medical condition started
  • How the medical condition limits the applicant's daily activities
  • What medical tests have shown
  • What treatments has the applicant received
  • How does the medical condition limit activities related to work, including sitting, walking, lifting and remembering instructions

Once this information about the medical condition is ascertained, the SSA has the state agency use a "five-step process" to make the determination about disability. The five questions the SSA has the state agency work through when deciding about one's disability status are:

  • Is the injured person working? If the applicant is working after the injury, the SSA will consider how much he or she is earning. If this amounts to more than a certain amount, based on a monthly average, than the person will not be found to be disabled.
  • Is the medical condition "severe"? To be considered disabled, the medical condition must limit the applicant's "basic work activities." Basic work activities include walking, sitting and remembering. The catch is that these limitations must be present for at least one year.
  • Is the medical condition on the List of Impairments? The SSA has compiled a list of medical conditions that are "considered so severe" as to automatically trigger a disability determination. If the medical condition suffered is not on the List of Impairments, the agency will look to see if the medical condition suffered is as severe as one on the list.
  • Can the injured worker do the work that he or she did before? The agency will consider if the medical condition prevents a worker from returning to the work done before. If the SSD applicant can return to that work, then he or she is not considered disabled.
  • Can the injured worker do another type of work? If unable to return to work done previously, the agency will consider if the worker can transition into other work. In making this determination, age, skill, medical condition and previous work experience will be taken into account. If the applicant can do other work, he or she will not be considered disabled.

If you have a medical condition and have questions about SSA and disability determinations, contact an experienced disability attorney in your area.