When injured or suffering from an illness that keeps you from work, it’s a good idea to make a disability insurance claim with your private policy provider or with the Social Security Administration (SSA). After filing a claim for short- or long-term disability benefits, your insurance provider or the SSA will take the necessary steps to verify the claim and ensure that your disability falls under their guidelines. Perhaps the most important part of the disability claim process is the disability evaluation.
The disability evaluation is a series of tests and/or examinations by the treating physician or an independent medical examiner. The information from the evaluation is then passed to the SSA (or insurance provider), who then decides whether to provide disability insurance benefits. With over 30 years of experience in the Houston area, disability benefits attorney William Herren can help you present a strong and thorough disability evaluation. We aim to maximize your chances for success, and all representation is done on a contingency basis (you don’t pay unless you win your case).
The Social Security Administration (SSA) follows a five-step evaluation plan when examining a claim. If the SSA determines that an individual is disabled or not disabled at a certain step, the evaluators make their decision and not continue onwards to the next step.
These steps follow the guidelines set forth by the Social Security Act, which defines a disability as, “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.”
Following these guidelines, the SSA’s five steps of the disability evaluation process include:
If an individual is working and makes more than the SGA level, then he/she is considered to be not disabled.
The individual must have a medically determinable condition that is severe and meets the duration requirements. The severity must interfere with work-related activities, and the impairment(s) must be expected to last twelve months or to result in death.
The SSA maintains a listing of medical criteria that are considered to be severe, and if the individual meets these criteria, then he/she may be qualified as disabled. If the individual meets the criteria, his/her residual functional capacity (RFC) is also assessed.
Using the individual’s RFC, the SSA completes a function-by-function comparison of RFC and past relevant work. If the individual retains a physical or mental capacity to perform past relevant work, he/she may be found to be not disabled.
The SSA evaluates the claimant’s RFC as well as age, education, and work experience to see if he/she can make an adjustment to other work.
Keep in mind, there are several nuances to each step in the disability evaluation process, ranging from special medical-vocation profiles to the three-part test evaluating past relevant work. In other words, the entire evaluation process can be time-consuming and fraught with complexities, and it’s essential to follow every step in a complete and comprehensive manner.
For the leading disability benefits attorney in Houston, make sure to call Herren Law as soon as possible. With years of experience helping over 4,000 individuals with their social security disability claims, we are confident that we can make the process straightforward, guide you through each step, and present a strong disability claim. For a free, no-obligation consultation with attorney William Herren, call our Houston law office today at (800) 529-7707.
Herren Law does not charge a fee for a consultation and we work on a contingency basis. You do not owe us anything unless you receive benefits.
We are here to help you in your time of need.
Complete the online form, call us at 1-800-LAW (529)-7707, (713) 682 8194 or send us an email for a free case evaluation. You will get a response within 24 hours.
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