How they decide about disability (18+)

How does Social Security make a decision about disability?

Image with the subject 'For adults over the age of 18 applying for SSI, Social Security will review these things:' above the text 'Their current job (if any), How severe their impairment is, If their impairment meets the guidelines for disabilities, Their work history, Their ability to do work now, based on: age, education and work experience.'

We will tell you how to apply for SSI in the other section on the menu. But here's a quick look at what happens behind the scenes as they decide about disability.

1. You will submit an SSI application to your local Social Security office.

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This has two parts - the first is an online form, but the second part is an interview that must be done in person.

 

2. The Social Security Office will check non-medical eligibility.

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They may ask questions about your family member's age, employment, marital status, citizenship, income, resources and housing.

 

3. Your case gets sent  to a Disability Determination Services office.

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They will look at medical records to see if your family member meets the guidelines.

 


4. The Disability Determination office makes a decision about your case.

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If they decide that your family member is disabled, they will tell the Social Security office who will tell you.

  

Click the box below for a little more detail:

Social Security has something they call the sequential evaluation process.

They follow certain steps in a certain order to evaluate if someone's disability qualifies for SSI.

  1. First, you submit an SSI application to your local Social Security field office. This has 2 parts, a disability form (you can do this online) and the SSI form. You can turn in the SSI form in person, by telephone, or by mail.

  2. After you submit the application, the field office checks non-medical eligibility. They may ask questions about your family member's age, employment, marital status, citizenship, income, resources, and living arrangements.

  3. The field office then sends the case to one of the state's Disability Determination Services offices. This office looks at all of the medical records to see if your family member meets the guidelines for being disabled or blind. If the office can't decide, they'll make a plan to get more information from your doctor. This may involve more tests, and is called a Consultative Exam.

  4. After making a decision about the disability, they return the case to the field office. The field office will tell you the decision.

  5. If they decide that your family member is disabled, Social Security will finish the paperwork, calculate the benefit amount, and start sending you the monthly checks.

  6. If the office finds that your family member is not disabled, they keep your files in the field office in case you decide to appeal. You can walk through How to Appeal an SSI Denial later in this Guide.

If the family member is found not disabled at any point, the review stops (unless they are over 65).

Source: Social Security.

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