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Who determines if I am eligible for disability benefits?

If you need Social Security disability benefits, it is important to understand who determines your eligibility and to also understand the process of applying for Social Security disability (SSD) benefits. Understanding the process, and how to navigate it, can help place the disabled individual in the best possible position to obtain disability benefits.

A disability benefits determination depends on several factors. The Social Security Administration initially reviews the application for disability to check that it meets basic qualifications which includes a review of the applicant's work history and any work activities the applicant is currently engaged in. The application is then progressed to a Disability Determination Services office in the state where the applicant resides. The initial decision concerning benefits is made by the state agency which reviews medical evidence from the applicant's doctor and any other medical care providers.

Doctors and disability specialists within the state agency are included in the application review process and review the applicant's medical condition; when the applicant's medical condition began; how the medical condition the applicant suffers from impacts their ability to work; as well as medical tests and treatment the applicant has received. Information from doctors related to the applicant's ability to perform work-related activities will also be reviewed including the applicant's ability to walk, sit, lift, carry and remember instructions.

Availability of SSD benefits is based on an inability work due to a physical or mental medical condition lasting longer than 12 months or that is expected to result in death. Because of the somewhat complicated application process, and the ability to appeal if denied disability benefits, it is important to disabled individuals to thoroughly understand how their claim for benefits is reviewed and how to best approach each step of the process.

Source: Social Security Administration, "Disability Benefits," Accessed Feb. 8, 2017

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Pennsylvania Bar Association Philadelphia Bar Co-Chair SSD Committee Philadelphia Bar Co-Chair SSD Committee