Claims E.S.P.

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   Ex Disability Examiner Reveals How to Get an Accurate Decision in the Least Amount of Time!  

 

9 Steps Disability Guide
 

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Your Adult Social Security Disability or SSI Claim:
The First 15 Minutes (continued)

 

Factors Considered including Age, Education,

Work History and Diagnoses

 

 

A ge : age as a factor is important because older disabled claimants have much fewer employment options than younger workers do, in certain instances, and Social Security uses a grid consisting of many factors to determine if you are disabled. So the grid begins with which age group you fall into. When I worked at DDS a several years ago, the age group categories for adult disability claims were from 18-44 years, from 45-49, from 50-54, from 55-60, and Approaching Retirement.

For example a 22 year old who is unable to do his past job of medium-level work because of h  is disability may be found to be able to still do light work, in spite of his limitations. Because he is a younger individual, the SS regulations theorize that while he may not be able to return to his previous level of work where he had to lift 50 pounds on occasion, he may be able to be rehabilitated or gain skills that would allow him to do light or sedentary level work in the future.

Consequently this younger individual would not be found disable, while an older worker over the age of 55 with the same physical disability and limitations might be found to be disabled based on the fact that he could not reasonably be expected at his age to take on a new skill or learn a new trade without great difficulty.

Education : persons who are well educated or have specialized technical or professional skills may be more marketable in the employment arena and thus, SS has this element as part of its grid which is used in the assessment of disability.

Education listed on the application can also clue the disability examiner in on the possibility that the claimant was placed in special education classes during his primary schooling (i.e. grades K-12th).

If a claimant was a special education student, per information obtained on his application, then this could indicate a mental challenge or impairment which could signal an additional block to that individual being able to obtain gainful employment after you consider his mental capacity when combined with any other physical disability he or she may be alleging.

For purposes of SS disability, any individual who indicates a history of special education in his schooling is in effect alleging a mental impairment as well. This knowledge of a history of special education alerts the examiner that the disability claim will have to be assessed for a mental disability even if the claimant is only alleging a physical cause of disability.

And since additional evidence has to be collected in mental disability claims, the examiner can begin sooner, rather than later, gathering required evidence to determine the extend of any cognitive or mental challenges.

Usually additional collateral contact (third party) forms will have to be sent to the claimant’s relatives, caregivers, friends or others who know of his mental limitations.

Work history: Ultimately, the disability examiner will be determining whether or not a claimant can a) go back to his past work, b) be able to do less demanding work, whether mental or physical in nature, or c) whether or not the claimant is unable to do any type of work because of the work limitations that his disability causes.

So work history, though it is generally one of the last areas assessed in a disability claim decision, it is a very important factor in the decision, especially as it relates to older individuals. So the claimant’s current work level is noted.

For physical disability claims-those not alleging a mental impairment--examiners can take a quick look at the grids, based on the claimant’s age, education and past work level, i.e. sedentary, light, medium of heavy work, and determine what level of work the claimant has to get down to in order to qualify for disability benefits.

So with the level of work needed to allow benefits, the focus now for the examiner now shifts to getting objective medical records and statements that support a work level at or below the Grid requirements.

[Next: Diagnoses]

 

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