What Kind of Evidence Is Used to Evaluate and Decide My Disability Benefit Claim?

by Jun 14, 2017

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An application for Social Security Disability (SSD) is a lengthy and extensive process that involves many steps and many parties reviewing your file. The Social Security Administration (SSA) uses different kinds of evidence to evaluate and decide your disability benefit claim. In order to minimize your wait time for a determination on your application—and to minimize the time you will spend waiting for your benefits—you should carefully gather as much supporting documentation for your disability claim as you can.

What evidence must I gather for my disability claim?

When you decide you are ready to file a disability claim, begin by organizing all of the items that you need to present with your claim. That includes a range of evidentiary documents that prove the existence of your disability.

Personal Statement

You will complete a statement testifying to the disability or disabilities that are preventing you from working and limiting or preventing your ability to do your job. In this statement, you will want to note the date of your disability or injury. This is most often the date from which the SSA will calculate your benefits, even if you filed your application at a later date.

Medical Records

You must also provide a medical history, which includes detailed information about your disability or disabilities, medical treatment history, and documentation to support the extent and permanence of your injuries. These medical records should establish:

  • The existence of an impairment;
  • The severity and permanence of the impairment;
  • Ongoing determinations and information on any changes the impairment; and
  • Evidence related to your symptoms, including prescriptions for drugs and their side effects, details on the intensity or severity of the disability or injury, information about daily activities, and other factors that are relevant to establishing the severity of the disability.

Activities of Daily Living Questionnaire

The SSA will also ask you to complete a questionnaire for insight into how your disability impacts your activities of daily living (ADLs). These activities can include:

  • Housework;
  • Personal care and hygiene activities;
  • Mobility or ability to drive;
  • Ability to run errands or perform basic activities, like shopping for food; and
  • Ability to sit or stand for extended periods of time.

Tempting though it may be to embellish your disability by claiming limitations beyond the scope of your injury, an inaccurate questionnaire may trigger an independent investigation. If that investigation uncovers evidence that your ADLs are not as impaired as you claim, the SSA can use that against you to deny you disability benefits. You should complete this form as accurately and honestly as possible.

Vocational History

Your job history, going back as far as 15 years, may help determine whether your job history is consistent with your inability to work. If your vocational training and work history have specific requirements, such as the ability to stand or kneel for extended periods of time, or if your job requires you to be able to perform specific physical functions, like carrying 50 lbs. or more, you should detail these requirements in your vocational history report.

You will also need to outline how your disability has prevented you from performing those specific functions and provide supporting documentation for each claim.

Consultative Exams

Depending on the completeness of the information you provide, you may have to participate in a consultative exam (CE) to gather additional medical data. This exam could include:

  • A physical examination;
  • A psychological test;
  • IQ testing; and
  • Comprehensive physical and psychological evaluations.

You should never stake your disability claim solely on medical evidence uncovered during a CE. The SSA will need extensive medical documentation—often more than what an examiner can discern from a short CE—to support your claim for disability. If you have not already made an appointment with your doctor, do so immediately. Speak with your doctor about your condition so he or she can begin documenting the extent and duration of your injury or disability.

Independent Investigation Reports

If the SSA has reason to suspect fraud, a Cooperative Disability Investigations (CDI) unit may perform an independent investigation to determine the validity of your claim. If your application claims limitations in certain daily activities but a witness observes you in public engaging in said activities without difficulty, that evidence may provide grounds to deny your claim.

What is the process of filing my claim?

When you apply for SSD benefits, you will first complete your application and paperwork. You will need to present that paperwork during a meeting with a representative at your local SSA office. The claims representative (CR) assigned to your case will serve as your main point of contact during the process.

Your CR will complete your file and forward it to a Disability Determination Services (DDS) examiner, who will work with a physician and psychologist consultant to determine the validity of your claim.

If DDS approves your claim, they will return it to the local office, where your CR will calculate the benefits owed and begin issuing payments. If they denied your claim, you will have to begin a lengthy appeal process before an administrative law judge.

How long is the application process?

The SSA typically processes claims within three to five months of receipt of the application. However, this time frame assumes no delays in receiving medical records or other relevant documents from your medical providers, employers, or other offices that the DDS office will contact.

If the SSA approves your claim, you should begin receiving payments and any back pay owed within 60 days. If the SSA denies your claim, however, your appeals process before a judge can take one year or longer.

How can I get help with my disability claim?

Minimizing the waiting time begins with submitting a complete, accurate, and detailed application with comprehensive information regarding your disability. The disability attorneys at the Disability Advantage Group can review your file and help you complete your claim accurately to minimize any delays in the process.

Our lawyers are available to help advocate for you during this long and complicated process. You can call us today for a free consultation at 865-546-1111.