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Understanding the SSDI decision process

Many Houston residents find that applying for Social Security Disability Insurance benefits can be a daunting. The social security disability review process involves the analysis of extensive medical information, review of employment records and evaluating the information in light of the claimant's past employment history. Familiarity with the process can make seem less overwhelming and can increase the likelihood of an application being approved.

Disability claims can be filed on-line or at a Social Security field office. In either case, the claimant must provide information about his or her personal background, documents verifying the medical nature of the disability and information verifying the effect of the illness or injury on the person's ability to perform substantial gainful employment, i.e., is the claimant in fact disabled? The claimant must include names and addresses of all medical providers, laboratory records, prior places of employment and the nature of the work performed.

SSA personnel will review the application and supporting documentation. The information is also forwarded to the Disability Determination Service in Texas for a decision on whether the claimant is disabled within the meaning of the law. Employees at the state agency will contact the claimant's medical providers to verify the claimant's medical and mental condition. The state agency will also question the claimant's medical providers about the effect of the injury or illness on the claimant's ability to work and whether the condition is likely to be either permanent or expected to result in the death of the claimant.

The SSA uses a five-step process to evaluate the claim. First, is the claimant working? Second, is the condition severe and does it significantly limit the claimant's ability to work? Third, does the condition satisfy the criteria for the condition that is published in SSA regulations? Fourth, can the claimant continue to do the kind of work that he or she was doing when the disability began? Finally, can the claimant do any other kind of work?

The claimant will be notified of the decision by letter. If the claimant disagrees with the decision, either because the claim was denied or because the allowed benefits are too low, the claimant can appeal the decision within the SSA or appeal to a federal court. Anyone considering filing a claim for SSDI benefits may wish to consult an experienced SSDI lawyer who can assist in preparing the application and in handling any resulting appeal.

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