Regardless of which medical impairment a person files a Social Security disability claim for, there are certain criteria that must be met, as defined by the Social Security Administration blue book.
First, an impairment must be considered severe. This means that it should prevent a claimant from working full-time or performing what is known as substantial gainful activity. Second, an impairment must be expected to be a permanent condition, or to result in death. For some medical condition listings, a specific duration must be specified, meaning that a treating physician should outline an expected timeline in a claimant’s medical record. If neither of these criteria are met, then medical records must plainly show that a claimant’s medical condition is expected to last continuously for at least 12 months.
In addition to these criteria, a Social Security Disability claimant must be able to provide medical proof of a diagnosis. In other words, he or she cannot simply claim to have a certain medical condition. If there are no treatment records or consultative exams on record, a disability claim will likely be denied.
Even if a claimant has been financially unable to obtain medical treatment, the Social Security Administration will likely schedule, and pay for, an exam with a contracted physician who can determine impairments prior to a decision being made.
It is always recommended that a party seek legal representation when he or she has been denied disability benefits. While mostly informal, Social Security Disability hearings contain certain legal aspects that claimant’s often do not understand when attempting to self-represent.