When a person’s claim for Social Security disability benefits is denied, there are a number of steps that should be pursued. An initial decision occurs at the administrative level, at the state Division of Disability Services. A denial at this stage may be appealed to an administrative law judge, and thereafter to the Appeals Counsel, and then to a federal court.
The criteria for determining whether medical problems and their effects warrant an award of Social Security disability benefits is the subject of many complex federal regulations. A brief discussion of the primary points, however, can be summarized. Initially, the question is asked whether someone is engaging in substantial gainful activity, that is, working. Assuming he or she is not, then the inquiry is made whether the medical problems are severe. If the medical problems are severe, then consideration is given as to whether these problems meet or equal a series of “Listings” spelled out in the regulations. If the impairments are found to be the same or equivalent to these listings, then he or she is considered disabled. Even if the listings are not met or equaled, further consideration is given to whether the person’s residual functional capacity, that is, the effects of the medical problems, prevents the performance of past relevant work. If the past relevant work can be performed, a decision is made that he or she is not disabled. If past relevant work cannot be performed, then the final question is whether other, less demanding work, can be performed, considering the person’s past relevant work, the residual functional capacity, age, education, past work experience, and skills that can be transferred from previous work to other jobs.
Someone denied Social Security should promptly obtain the assistance of an attorney, because, in addition to the eligibility criteria established in the regulations, there are deadlines established for preserving appeal rights at each stage of the process.