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What Is Considered to Be a Medically Determinable Disability?

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Many people develop serious medical conditions as a result of their age, workload, and lifestyle. If you suffer from a medical condition that hinders your ability to work and go about your daily tasks, you may consider applying for monetary benefits from the Social Security Administration (SSA). 

However, before you begin the application, you should know the criteria you must meet to qualify. To be eligible, you will have to prove that your impairment is medically determinable. A lack of sufficient evidence can lead to the denial of your claim. 

Millions of citizens receive benefits from programs that the SSA administers. However, most individuals who apply for SSA benefits receive rejections because they lack critical documentation of their disability. According to official data released by the SSA, more than 5 million people were newly awarded benefits in the year 2019. 

This handy guide can help you understand how the SSA defines a medically determinable disability and what you will need to prove to qualify. In addition, you will understand the differences between Social Security Disability Insurance (SSDI) and eligibility for Supplemental Security Income, or SSI eligibility.

Medically Determinable Disability 

As defined by the SSA, a medically determinable disability is a physical or mental impairment that limits your ability to work. The diagnostic tests and medical reports must reveal that your condition is severe. 

No matter how serious your symptoms may be, the SSA will not approve your application without convincing evidence. Therefore, you should have proper clinical reports and laboratory findings that show the severity of your condition. 

You must also undergo appropriate medical treatment to prove that your condition is medically determinable. Your healthcare provider’s treatment records can play a critical role in getting approval. The SSA may not approve your application if you have not undergone treatment for your condition. 

Medically Determinable DisabilityWhether your impairment is physical or psychological, an applicant must submit medical evidence and test results. You should not hesitate to ask for assistance from your healthcare provider and your attorney. Be frank and communicate whatever doubts you have in mind. 

The SSA will not consider your impairment to be a medically determinable disability if your doctor’s diagnostic results do not support your claim for benefits. Therefore, you should focus your energy on gathering the evidence for a strong application. Your doctor’s diagnosis and statements can help to establish your impairment and help you get the approval.

Does the SSA offer benefits for short-term conditions?

Short-term benefits aid individuals who suffer from a short-term or a non-work-related health condition. Many applicants often get confused about this matter. It is critical to understand that SSA does not offer any type of short term disability benefits. 

For you to be eligible for SSDI, your condition must have prevented you from working for at least a year. To get approved for SSI, you must meet certain income limits. 

SSDI and SSI are two different programs with different eligibility conditions. If you have any confusion about which one you should apply for, you can visit the Social Security Administration’s official website for additional information. 

What medical evidence does the Social Security Administration require? 

Medical evidence plays a critical role in getting approval from the SSA. The SSA may request additional information from your healthcare provider and will evaluate all of the records your doctors provide. For instance, people with epilepsy will have to provide evidence of their debilitating condition. The documentation must state the type and the frequency of the seizures that you experience. 

If you do not meet the listing, you may still be able to get approved under the medical-vocational allowance. However, medical evidence remains mandatory to qualify for benefits, and you will have to show all of your records. The following are the types of medical records and evidence that you should submit to the SSA with your application: 

  • History of your medical impairment
  • Information about when you were diagnosed with the condition
  • Laboratory findings and diagnostic test results
  • Current diagnosis
  • Clinical examination results
  • Prescribed treatment and prescription records
  • Your body’s response to the treatment

In addition to these documents, you should also have a statement from your doctor that lists all of the limitations you have. This list should include all of your limitations that relate to both your mental health and your physical health that have developed because of your disabling condition. 

The evaluators at the SSA may even ask that you undergo consultative exams to provide additional evidence with regard to your application. Based on your examination, a doctor will evaluate the claims that you have mentioned within your application. 

Based on the test results and records that you submit along with your application for benefits, the SSA will make its decision with regard to whether you will qualify. The evaluators will look closely at whether your symptoms actually limit your ability to work and function. Different medical conditions may have different criteria that applicants must meet to receive benefits. 

For instance, you will likely be required to submit psychological and neurological test reports for disability benefits based on a diagnosis of dementia. You may even have to undergo several additional tests for some of the qualifying conditions. 

Having comprehensive medical records can increase your chances of getting approved for the benefits that the SSA provides. It is also important to have a Social Security disability lawyer by your side to make this process as simple and painless as possible.