Initial Claim Application
The initial claim application is filed at the local Social Security office. Among other things, you will need to provide details on all of your medical treatment, as well as your work history for the last fifteen years. Once the application is complete it is sent to Disability Determination Services (DDS), the government agency responsible for processing disability claims. DDS gathers your medical records and a team of medical and vocational personnel review your file and issue a decision.
After all of your medical records arrive, a DDS worker (called an examiner) sends your records to a medical consultant. The medical consultant, usually an M.D. or Ph.D., will review the records and come up with your residual functional capacity (RFC). The RFC is a medical opinion that identifies what you can do and for how long.
An RFC for a physical impairment will estimate how long you can sit, stand and walk for in an 8-hour workday. It will also include an opinion of how much weight you can lift and carry occasionally and frequently. “Occasionally” is defined as up to 1/3 of the workday, and “frequently” is defined as from 1/3 – 2/3 of the workday.
The least physical jobs are sedentary jobs (desk jobs). In order to be capable of performing sedentary work, you must be able to sit for approximately 6 hours and stand and/or walk for at least 2 hours in an 8-hour workday. Sedentary work does not involve a lot of lifting and carrying. Generally you do not lift more than 10 pounds at a time at a sedentary job. The more weight you are capable of lifting, the more physical the job.
Light work requires the ability to lift and carry 10 pounds frequently, and 20 pounds occasionally. If you are able to lift and carry up to 50 pounds occasionally and 25 pounds frequently, then you are capable of medium work. Heavy and very heavy work involves jobs lifting up to or more than 100 pounds. Construction work can be characterized as heavy or very heavy work.
A physical RFC also rates your postural limitations, including climbing, balancing, stooping, kneeling, crouching and crawling, as well as manipulative limitations such as reaching, handling, fingering, and feeling. Visual limitations, communicative limitations, and environmental limitations like exposure to extreme heat, extreme cold, wetness, humidity, noise, vibration, fumes, and hazards are also assessed by the medical consultant.
A mental RFC lists the degree of impairment found in various nonexertional capacities such as memory, concentration and socialization. The medical consultant will offer an opinion in the areas of understanding and memory, sustained concentration and persistence, social interaction and adaptation. Marked impairment in these areas will generally preclude work activity.
The Social Security Administration also recognizes that the inability to perform basic work-related mental activities such as understanding, carrying out, and remembering simple instructions; using judgment in making work-related decisions; responding appropriately to supervision, co-workers and usual work situations; and dealing with changes in a routine work setting warrants a favorable decision in your case. Unfortunately, RFC forms completed by DDS medical consultants are rarely of any benefit to you. At DDS, RFC forms are used to facilitate denials significantly more often than approvals. That’s why it’s important to get your treating doctor to fill out an RFC for you.
We Help File Your Initial Application
At Rob Levine and Associates, we have created forms for your doctor to complete, which provide us with the necessary medical evidence to establish your disability under the Social Security rules. Your treating physician’s opinion on your inability to perform work activity is the best way to refute the RFC assessments made by the DDS medical consultants. After all, your doctor is in the best position to comment on your limitations. He or she has had the opportunity to get to know you over a period of time. And more significantly, unlike the DDS medical consultant, your doctor has examined you!
Social Security gives substantial weight to the opinion of your treating physician as long as the opinion is consistent and well-supported by the other medical evidence associated with the case. A statement by your doctor simply saying that you are disabled will not suffice. Whether you are disabled or not is a determination reserved to the Social Security Administration. Instead, it is necessary for your doctor to identify limitations resulting from your medical condition, which, in turn, can be used in assessing whether those limitations prevent you from working.
Once your limitations have been identified, your file will be evaluated by a vocational expert. Vocational experts study jobs in order to understand their physical and mental requirements. They are qualified to determine the exertion and skill levels of various jobs, as well as the industry-standards for many occupations. At step 5 of the sequential evaluation process, the vocational expert identifies whether other jobs exist in the national economy which you can perform despite the limitations contained in your RFC.
You should expect to receive a denial of your claim at this level. Statistically, the overall majority of claims are denied. If you receive a denial, you should appeal. Social Security requires that you file the appeal within 60 days. If you miss the deadline, you will have to file another initial claim application and could lose benefits. In most states, you need to file a request for reconsideration to appeal.