The most important part of one’s claim for Social Security Disability Insurance (SSDI) benefits or Supplemental Security Income (SSI) payments is your medical records (i.e., a paper-trail of your medical problems). A claim will not go anywhere without proper documentation of your impairments.
In order for an attorney to properly evaluate your claim for either SSDI or SSI, we will need to see documentation of your impairments. Why? Because the Social Security Administration is evaluating your file and looking at the same thing an attorney is: your medical records. In order for a claimant to be found disabled, his/her medical impairments must either meet or equal a listing of disability, or place the individual at level that prevents his/her ability to engage in substantial gainful activity.
The Social Security Administration will make a medical assessment to determine whether an individual’s impairment(s) meets a listing in the Listing of Impairments. If an individual’s impairment(s) meets ALL the criteria of any listed impairment in the listings, the Social Security Administration, after reviewing your medical records, will find that individual is disabled.
However, if an individual has an impairment(s) that does not meet all of the requirements of a listing, the Social Security Administration will determine if an individual’s medical impairment(s) medically equals a listed impairment. An impairment is medically equivalent to a listed impairment if it is at least equal in severity and duration of the criteria of any listed impairment. The Social Security will find medical equivalence in three (3) ways:
- If an individual has an impairment that is described in the listings but either:
- The individual does not exhibit one or more of the findings specific in the particular listing, or
- The individual exhibits all of the findings but one or more of the findings is not as severe as specific in the particular listing.
If that is the case, then the Social Security Administration will find the individual’s impairment is medically equivalent to that listing if there are other findings related to the impairment that are at least of equal medical significance to the required criteria.
- If an individual has an impairment(s) that is not described in the listings, the Social Security Administration will compare the findings with those for closely analogous listed impairments. If the findings related to the impairment(s) are at least of equal medical significance to those of a listed impairment, the Social Security Administration will find that the impairment(s) is medically equivalent to the analogous listing.
- If an individual has a combination of impairments, no one of which meets a listing, the Social Security Administration will compare the findings with those for closely analogous listed impairments. If the findings related to the impairments are at least of equal medical significance to those of a listed impairment, the Social Security Administration will find that the combination of impairments is medically equivalent to that listing.
If the Social Security Administration determines that an individual’s impairment(s) does not meet or medically equal a listed impairment, the Social Security Administration will continue to evaluate an individual’s claim using the sequential evaluation process in order to determine what functional limitations, both exertional (physical) and non-exertional (mental/cognitive), result from your impairments.
As you can see, your medical records are paramount to your claim for SSDI benefits or SSI payments. Furthermore, for an attorney to properly evaluate your case, a review of your medical records is necessary to determine what type of case you have. Do you have an impairment that meets a listing? Equals a listing? Or do your impairments cause functional limitations and if so, to what degree?
If your impairments do not meet or equal a listing, we must look to what functional limitations result from your impairments and then compare your restrictions with the demands of any past relevant work you have performed in the last fifteen (15) years. Furthermore, depending on your age: 18-49, 50-54, 55-59, or 60+, and your education: marginal (6th grade or less), limited (7th grade to 11th grade), or high school education and above (12th/HS graduate+), and how your impairments limit you, you may or may not be found disabled.
As a result, your medical records (and medical treatment) are vital to your claim for SSDI benefits or SSI payments for not only the Social Security Administration but also any attorney reviewing the merits of your case.
Remember, be sure to bring medical records with you, or forward those records ahead of time, to your appointment with an attorney in order to aide the attorney’s review of your claim.
The information contained herein is for general information purposes only and is not meant for your reliance on, or to form a basis, for any legal, business, or other decisions. As always, if you have any legal questions, consult an attorney.