Disability Decision Making

SSA will review your application to make sure you meet some basic requirements for disability benefits. They will check whether you worked enough years to qualify. Also, they will evaluate any current work activities. If you meet these requirements, SSA will send your application to the Disability Determination Services office in your state.

This state agency completes the disability decision for them. Doctors and disability specialists in the state agency ask your doctors for information about your condition. They will consider all the facts in your case. They will use the medical evidence from your doctors and hospitals, clinics or institutions where you have been treated and all other information. They will ask your doctors:

• What your medical condition is;
• When your medical condition began;
• How your medical condition limits your activities;
• What the medical tests have shown; and
• What treatment you have received.

They also will ask the doctors for information about your ability to do work-related activities, such as walking, sitting, lifting, carrying and remembering instructions. Your doctors are not asked to decide if you are disabled.

The state agency staff may need more medical information before they can decide if you are disabled. If more information is not available from your current medical sources, the state agency may ask you to go for a special examination. They prefer to ask your own doctor, but sometimes the exam may have to be done by someone else. Social Security will pay for the exam and for some of the related travel costs.

They use a five-step process to decide if you are disabled.

When the state agency reaches a decision on your case, they will send you a letter. If your application is approved, the letter will show the amount of your benefit and when your payments start. If your application is not approved, the letter will explain why and tell you how to appeal the decision if you do not agree with it.

If you disagree with a decision made on your claim, you can appeal it. The steps you can take are explained in The Appeals Process.