- The Social Security Administration awards benefits to disabled individuals who prove the existence of a long-term mental or physical disability. The disability must prevent the individual from performing a significant or substantial major life activity. The Social Security Administration performs a medical disability determination to assess qualification for benefits. The Social Security's Medical Determination Services performs the medical and qualification assessments. The Determination Services agencies use the Code of Federal Regulations definitions to determine whether each applicant's disability is medically sufficient to preclude enjoyment of a major life activity.
- The Code of Federal Regulations lists disability by category or type of disability the applicant is claiming to have. Categories within the Code of Federal Regulations include Part A or Adult Disabilities and Part B, Childhood Disabilities. Each part is further broken down into known skeletal, muscle, nerve, limbic, mental and other major systemic disabilities. The determinations office will use the definitions within the lists to make an assessment if the individual is claiming the existence of an unlisted disability.
- To receive benefits, the Social Security Administration requires the applicant have a permanent disability that has persisted continuously for at least 12 months and it could ultimately lead to the applicant's death. The Social Security Administration requires applicants to submit paperwork, including medical certification from licensed physicians of the existence of the disability and their medical opinion as to the extent of the disability. The Social Security Administration's ultimate determination decision depends on the medical proof and physical examinations or behavioral assessments of qualified professionals. Additionally, for Supplemental Security Income, applicants must show limited financial resources.
- The Social Security Administration also reviews non-medical evidence for determination purposes. However, the administration places special weight on certifications from treating sources or licensed physical and mental professionals who have been responsible for treating the applicant. The administration also requests evidence from any health facilities, hospitals and clinics that may have treated the applicant for related ailments. The Social Security Administration may require special medical consultations if the submitted evidence does not sufficiently prove the existence of a permanent disability.
- Since disability laws can frequently change, you should not use this information as a substitute for legal advice. Seek advice through an attorney licensed to practice law in your jurisdiction.
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