There are basically three ways to win a Social Security disability claim. One way is to meet or equal one of the listings. The "listings" refer to the Code of Federal Regulations, Part 404, Subpart P, Appendix I (often called "Appendix I" or simply "the listings." This appendix classifies impairments according to fifteen body systems, with each impairment given detailed criteria for the severity required for disability. It is often very difficult to meet or equal a listing because they are so precise and defined.
The second way to win a disability claim is to qualify under a "grid rule." Grid rules refer to Appendix 2 of the same section of law referred to above. The "grid" considers the claimant's residual functional capacity (what he/she can still do in terms of physical limitations/ability), age, education and skill level. When all of these factors combined direct a finding of disabled, the case has been won. I have found it somewhat easier to win a case under criteria provided by the grid rules than under the listings.
The third way to win a disability case does not require meeting a listing or necessarily satisfying a grid requirement. In this type of case, the grid rules are used merely as a framework. The claimant must show that he/she has an impairment or combination of impairments that result in a severe limitation of physical and/or mental function that results in a significant erosion of the occupational base. Often, mental or emotional impairments play into this type of case. (Psychological impairments are considered under the "listings" of Appendix I, but not under Appendix 2). Grid rules don't apply to mental impairments.
It often boils down to this question in the end: Can this claimant, giving the particular set of medically determinable impairments present, perform any work?" If the answer is "Yes," then the claimant is not disabled under Social Security rules.
No wonder most claimants are denied at the initial level--because decision makers have no met the claimant, often have not examined the claimant, and may or may not have sufficient medical evidence to make a valid determination. Unfortunately, in those cases, the claim is often denied, leaving it up to an administrative law judge to sort things out in the appeal hearing.
The second way to win a disability claim is to qualify under a "grid rule." Grid rules refer to Appendix 2 of the same section of law referred to above. The "grid" considers the claimant's residual functional capacity (what he/she can still do in terms of physical limitations/ability), age, education and skill level. When all of these factors combined direct a finding of disabled, the case has been won. I have found it somewhat easier to win a case under criteria provided by the grid rules than under the listings.
The third way to win a disability case does not require meeting a listing or necessarily satisfying a grid requirement. In this type of case, the grid rules are used merely as a framework. The claimant must show that he/she has an impairment or combination of impairments that result in a severe limitation of physical and/or mental function that results in a significant erosion of the occupational base. Often, mental or emotional impairments play into this type of case. (Psychological impairments are considered under the "listings" of Appendix I, but not under Appendix 2). Grid rules don't apply to mental impairments.
It often boils down to this question in the end: Can this claimant, giving the particular set of medically determinable impairments present, perform any work?" If the answer is "Yes," then the claimant is not disabled under Social Security rules.
No wonder most claimants are denied at the initial level--because decision makers have no met the claimant, often have not examined the claimant, and may or may not have sufficient medical evidence to make a valid determination. Unfortunately, in those cases, the claim is often denied, leaving it up to an administrative law judge to sort things out in the appeal hearing.
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