The Way the Social Security Administration Defines "Disabled"
Working with the Social Security Administration can be confusing for people who are not experienced with the Social Security regulations because the Social Security Administration uses technical and sometimes unique definitions for many of the terms in its requirements.
An example of this comes up with the word “disabled,” which is the first word that comes up in a Social Security disability case.
The Social Security Administration defines “disabled” differently than insurance companies and other government programs
Private insurance companies, workers’ compensation programs, the Veteran’s Administration, and the Social Security Administration all have their own definitions of “disabled.”
Therefore, the fact that you may have been determined to be disabled in some other context has no particular relevance when it comes to the Social Security Administration’s determination of whether you qualify for Social Security disability benefits.
The meaning of “disabled” for purposes of Social Security disability benefits
For purposes of Social Security disability benefits, the concept of “disability” is based on your ability to work, so you are considered “disabled” if you are unable to work.
More specifically, in the words of the Social Security Act, a “disability” is the inability to do “substantial gainful activity” as a result of a “medically determinable … impairment” that is either expected to result in death or that has lasted or is expected to last for 12 months.
The Social Security Administration also has a complex definition for “substantial gainful activity,” however, essentially that phrase refers to either your previous job or any other kind of substantial employment.
The way the Social Security Administration decides whether or not you are disabled
The Social Security Administration uses two different systems for its process of deciding whether or not you are disabled.
The first system is used when you first file your disability application. For that evaluation, the Social Security Administration has an agreement with a local California state agency for that agency to make a decision about whether to grant or deny your claim. That decision is based solely on the application and reports in your file. That is, the examiner does not meet you, but simply reads the file. For most people, the result at this point is a denial of the claim. In some places it is possible to ask for reconsideration of this decision, but most claims are also denied upon reconsideration.
The other system is used for appeals after denials. Appeals are handled by Administrative Law Judges who work for the Social Security Administration. The Administrative Law Judge holds a hearing where you can appear and give testimony and be represented by a disability lawyer.