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How Your Condition Affects Your Ability to Function: The Key to Social Security Disability Benefits

By R. M. Bottger

When making the decision on your claim for Social Security disability benefits, the Social Security Administration will want to know how your condition affects your ability to function.

            For some conditions, the Social Security Administration does not look directly at your ability to function. For example, if you have small cell carcinoma of the lung and the surgical and pathology reports to confirm it, then you will be found disabled.  However, anyone with these conditions will have severe limitations in his or her ability to function. For most conditions, the Social Security Administration will look more directly at how your condition affects your ability to function in order to determine your eligibility for Social Security disability benefits.

The Social Security Administration will want to know how your condition affects your ability to do work-related functions. When I was a disability determination specialist, male claimants would often start to tell me about their impotence. However distressing that condition may be, that particular function is not needed in order to work; therefore, it is not relevant to oneís claim for Social Security disability benefits. Examples of abilities that are needed in order to work are lifting and carrying, seeing, hearing, speaking, and using oneís hands. (See Your Ability to Do Physical Work-Related Functions and Your Social Security Disability Claim.)  Examples of mental work-related abilities are intellectual functioning, memory, concentration, the ability to get along with coworkers and supervisors, the ability to get along with the general public, and the ability to adapt to routine changes in the work environment. (See Your Ability to Do Mental Work-Related Functions and Your Social Security Disability Claim.)

You should be sure to tell Social Security all of the ways that your condition limits you. The Social Security Administration will then need medical evidence to confirm your limitations in order to determine your eligibility for Social Security disability benefits.

To illustrate how your ability to function affects SSAís decision, take the example of the cardiovascular accident, which most people call a stroke. A diagnosis of a stroke alone is not enough for the Social Security Administration to determine if somebody is eligible for Social Security disability benefits. Some people who have stokes have very little residual limitations. Some people who have strokes die. There is a wide range of limitations between these two extremes. In the case of a cardiovascular accident, Social Security will want to know how the personís ability to function is limited. Does he or she have weakness on one side of his or her body? If so, how does it limit him or her? Is his or her ability to walk limited? If so, how is his or her speed and safety affected? Is he or she confined to a wheelchair? Does she or he require a cane or walker in order to walk? Is the use of his or her hands limited? If so, what is his or her grip strength? How is his or her gross manipulation limited (for example, the ability to use a hammer or turn a doorknob)? How is his or her fine manipulation limited (for example, the ability to write with a pencil or fasten a button)? Is his or her speech limited? If so, what percentage of his or her speech is intelligible? Is his or her vision affected? What is his or her visual acuity? Is he or she having mental problems as a result of the stroke? Is she or he having memory loss (there are standardized tests to measure memory)? Is he or she having poor concentration, depression, anxiety, or other mental problems? If so, the Social Security Administration will want more information as to the severity of the impairment. Does he or she have any other mental or physical impairments as a result of the cardiovascular accident? What daily activities is he or she no longer able to do as a result of his or her cardiovascular accident (such as drive a car, read, bathe alone, etcetera)? From this example, you can see that the Social Security Administration requires detailed information about how a personís ability to function is limited in order to determine eligibility for Social Security disability benefits.

The ability to function is so important that sometimes a diagnosis is not even necessary for a case to be an allowance. For example, when I was a disability determination specialist, I had a case of a fellow who could not walk due to severe atrophy of the muscles in his legs. He went to doctors all over the country, but nobody could figure out what was causing the atrophy. No doctor was able to provide a diagnosis. The Social Security Administration did not have to take his word for it that he could not walk. Each doctor he went to measured the circumference of his legs. The medical records clearly documented that the circumference of his legs got smaller and smaller over a period of several months. Each doctor documented the strength of his leg muscles and his reflexes. It was quite apparent that nobody with legs muscles that small could walk. Because he could not walk, he was found disabled even though he had no diagnosis.

Take every advantage of every opportunity to tell the Social Security Administration how your condition limits your ability to function. When you fill out forms to apply for Social Security disability benefits, be sure to take every opportunity to state how your condition limits you. When you talk to your disability determination specialist on the phone, tell him or her how your condition limits you. If you go to an examination for the Social Security Administration, tell the doctor how your condition limits you. If you have your own doctor write a letter to the Social Security Administration regarding your claim for Social Security disability benefits, have your doctor state how your condition limits your ability to function. Make sure the Social Security Administration understands how you are limited.

 

 

 

  

 


 
 

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