Factors Involved in The Social Security Disability Process

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In order for a disability determination to be made on a disability claim, medical evidence must be obtained from an individual's medical sources.

For disability claims involving children, school records, psychological testing, IQ scores, IEPs, and speech language assessments are pertinent in making a disability decision. In addition, the individual's perspective (parent/teacher's perspectives in a child's claim) on his/her activities of daily living is needed to support the allegations in the claim.

Social Security Disability adheres to a set of rules established in the Policy Operations Manual (POMS).

Social Security Disability claims need to be well documented to prove that an individual is eligible for disability benefits.

While most medical sources submit medical records for a disability claim, some medical sources do not submit the necessary medical records needed to make a decision. In this situation, Social Security may send an individual on a consultative examination to gain further insight into an individual's disability.

Factors Involved in Processing Disability Claims:

The length of time that it takes for your medical sources to respond to the request for medical evidence.

Is the information in your file sufficient (according to Social Security's Disability guidelines) to make a decision, is more information needed

• Does the individual need to attend a consultative examination and if so did the individual attend all consultative examinations
• Did the individual complete and return the activities of daily living forms and work history forms

Once a decision is made on a disability claim, the claim may be chosen for quality review.

Certain disability claims involving impairments such as: a stroke, heart surgery, and traumatic brain injury, may be placed on medical hold for 90 days after your surgery or injury to evaluate your residual functioning.

If you are hospitalized for any reason while you have a pending disability claim (depending on the nature of your situation) a six week follow up is needed after discharge to assess your residual functioning.

If you go out of town for an extended period of time this may cause delays and holds on your claim, especially if disability needs you to attend a consultative examination. If you are out of town for 60 days or more, your claim may be transferred to that particular location.

Inconsistencies in your work history may also cause delays in your claim. If you are awarded benefits and work issues become a factor, this may cause delays in the claim.

This information may not be comforting considering that must people applying for disability have an immediate financial need. It is pertinent that you be aware of the variables at play, so you or your disability advocate can possibly avoid or eliminate some of the barriers in the system and possibly obtain your disability benefits. The more that you know about the process, the better you are able to navigate and avoid some pitfalls of the system.

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