Are you “disabled” according to the Social Security Administration?
Many applicants for Social Security disability benefits in central New Jersey wonder why their initial applications were denied. This is especially true for applicants who are disabled according to the Veterans’ Administration or Workers Compensation. The answer is that the Social Security Administration’s definition of “disabled” is different from what you might expect and different from the definition used by other disability benefit programs.
Who decides whether you are disabled in New Jersey?
After you file your Social Security disability claim, a disability examiner and medical consultant at the New Jersey Disability Determination agency make the initial decision. If they deny your claim and you request reconsideration then your case is sent to a different disability examiner and medical consultant who reconsider it.
If your claim is denied again at the reconsideration stage then you may request a hearing. For the hearing, your case is sent to an Administrative Law Judge who works for the Social Security Administration. This Administrative Law Judge will hold a hearing and make an independent decision on your claim. The Administrative Law Judge is the only decision maker that you will get to see (and the only one who will see you rather than just look at records).
How does the Social Security Administration define “disabled”?
The Social Security Administration’s definition of “disability” is based on your ability to work.
Specifically, the Social Security Act defines the term “disability” as an inability “to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”
This means that to qualify as “disabled” for purposes of Social Security disability, you have to satisfy the examiner or the Administrative Law Judge that:
- You have a severe physical or mental condition that has lasted or is expected to last for a year or result in death.
- You cannot do the work that you used to do because of your condition.
- You cannot adjust to other work because of your condition.
How does the Social Security Administration decide whether you are disabled?
Social Security regulations provide a five-step process for determining disability. These five steps are as follows:
- You are not engaging in “substantial gainful activity.”
- You have a “severe” impairment.
- Your impairment meets or “equals” one of the impairments described in the Social Security regulations known as the “Listing of Impairments,” in which case you will be disabled; or
- Considering your “residual functional capacity” (that is, what you can still do even with your impairments), you are unable to do “past relevant work.”
- There is no other work within your “residual functional capacity” in the national economy in significant numbers.
Watch out for all of the terms identified by quotation marks. Those terms have precise meanings in the regulations and rulings that are not necessarily the meanings you would expect.
What is “other work”?
For the Social Security Administration, “other work” does not mean work in your local area or work that you want to do. Instead, for its definition of “other work” the Social Security Administration means that you cannot do “any other kind of substantial gainful work which exists in the national economy.”
Since there is some sort of job for almost everyone, it can be difficult to meet this requirement of an inability to do other work.
The examiner or the Administrative Law Judge uses charts or grids called the Medical-Vocational Guidelines to determine whether you can work depending on your “residual functional capacity.”
For more information on the Listings, past relevant work, residual functional capacity, and the Medical-Vocational Grids, see Theories for winning your Social Security disability hearing.
We are here to help
The Social Security Administration rules are technical and complex. If you are not already represented by a New Jersey Social Security disability attorney, please feel free to contact us for an evaluation of your case.
You may email or call our office, or fill out the form to the right.
Zager Fuchs, PC
New Jersey Social Security disability attorneys
E-mail
Phone: 732-747-3700
Fax: 732-747-2533
P.O. Box 489
268 Broad Street
Red Bank, New Jersey 07701
