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The “Burden of Proof” in a Social Security Disability Claim

   Although you may have paid thousands of dollars into the Social Security system, you are not automatically entitled to disability benefits once you have come to the difficult decision that you are unable to work.

   In fact, the burden of proving that you are disabled falls on you, not on the Social Security Administration.

   In your Social Security case, you must prove that because of a documented and medically recognized medical or mental health condition you are unable to engage in substantial gainful activity. Further, you must prove that your condition is not temporary - it must have lasted for a year (or is expected to last at least a year) or result in death.

   Let’s look at each of these elements:

  • medically determinable condition - you must prove to Social Security that you have a diagnosed problem and that your medical diagnosis falls within the scope of accepted medicine.  Social Security gives little weight to “alternative” medicine and its diagnoses.   For example, Social Security does not give much weight to diagnoses of chiropractors or holistic medicine practitioners.
     
  • substantial gainful activity - your medical condition must prevent you from performing work or work-like activity.  Social Security sees work as non-leisure activity that you perform approximately 8 hours a day, five days a week.   However, volunteer activities may also be substantial activity as can your enrollment in school.
     
  • duration requirement - impairment must last a year.  As noted above, Social Security disability does not pay benefits for disabilities that are short term (although some State plans do cover short term disability).  A normal pregnancy is not a condition that will support an SSA disability claim.  If your condition is terminal, such as AIDS or some forms of cancer, SSA may approve your claim because your condition is expected to result in death

As the claimant for disability benefits, you must prove that you qualify for benefits.  You do this by submitting medical evidence that addresses the limitations in your work capacity, evidence in the form of statements or testimony from former co-workers, friends, relatives and others who have personal knowledge about how your medical condition limits your capacity for substantial activity.

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