THINGS YOU MUST PROVE TO GET DISABILITY BENEFITS

It's called Burden of Proof.  In any legal proceeding there are things that you have to prove.  A Social Security disability claim (or hearing) is no different.  Here are the essentials that you must prove to prevail:

  • You are covered for Title 2 claims under the Social Security Act (unless you are filing for SSI only under Title 16).
  • You are not currently working at substantial gainful activity.
  • You have at least one severe impairment that can be medically determined by objective medical evidence.
  • Your impairment(s) pose a significant limitation on your ability to perform work activities.
  • You are not able to perform any of your past relevant work.  This is especially imperative if you are under age 50.
  • There is no other work that exists in the national or state economy that you are able to perform.

Some of these things are easier to prove than others.  I will make a few brief observations about medical evidence.

First, medical evidence must be objective--that is, supported by laboratory tests, X-rays, MRIs or CAT scans, etc.  The evidence must come from what Social Security considers an accepted medical source under 20 CFR 404.1527.  Typically this would be a medical doctor (MD), doctor of osteopathic medicine (DO), or a licensed clinical psychologist (Psy.D or Ph.D).  There are exceptions.  For instance, an optometrist (OD) can provide evidence for eye or visual disorders; a podiatrist (DPM) can provide evidence of foot disorders.  The following are examples of professionals NOT considered accepted medical sources by Social Security:  counselors, therapists, social workers, chiropractors, nurses or nurse practitioners.  

Finally, medical evidence must demonstrate significant limitations in the ability to perform work-like activity, such as walking, standing, lifting, bending, etc.  If the impairment is psychological or mental in nature, evidence must show limitations in such functions as comprehension, concentration/attention, ability to follow instructions, to respond appropriately to co-workers, supervisors or the public; or difficulty with adjusting to the demands of a routine work schedule.

Collecting, evaluating and interpreting medical evidence in light of Social Security laws and regulations is best performed by a trained advocate or attorney. 



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