In order to qualify for Social Security Disability Insurance Benefits, you must first be able to establish that you meet the Social Security Administration’s basic definition of disability. Social Security defines disability “as the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to last for a continuous period of not less than 12 months.” (See 20 CFR §404.1505).
What does Medically Determinable Physical or Mental Impairment Mean?
A medically determinable physical or mental impairment is a medical condition that can be shown to exist by medically acceptable clinical and laboratory diagnostic techniques. (20 CFR §404.1508). Social Security Regulations specifically state, “a physical or mental impairment must be established by medical evidence consisting of signs, symptoms, and laboratory findings, not only by your statement of symptoms.”
Even if you have a number of symptoms that are preventing you from working, if you have not received a diagnosis, you cannot be found disabled. (See 20 CFR §404.1529). This is why medical treatment is so important to Social Security disability claims. If your symptoms, such as pain, fatigue, weakness, or nervousness, are not explained with medical signs or laboratory findings that show a medically determinable impairment, Social Security cannot determine that your symptoms affect your ability to do basic work activities. (See 20 CFR §404.1529).
Obtain a Medically Supported Diagnosis Before Applying for Disability Benefits.
If you are experiencing symptoms that prevent you from working, you must receive treatment to determine the cause of your limitations. Once you receive a diagnosis, your symptoms must be supported by signs and laboratory findings. “Signs are anatomical, physiological, or psychological abnormalities which can be observed, apart from your statements.” (20 CFR §404.1528). Laboratory findings are “anatomical, physiological, or psychological phenomena which can be shown by the use of medically acceptable laboratory diagnostic techniques.” (20 CFR §404.1528).
In the simplest form, you must receive treatment, your doctor must confirm that the symptoms you express are occurring, and test results should support the diagnosis. If you have not been diagnosed, or your diagnosis is not supported by signs and laboratory findings, you cannot be found disabled.
I suggest to my clients that they have open conversations with their doctors about their medical condition. If you are unable to obtain a diagnosis from your primary doctor, ask for a referral to a specialist. If you are diagnosed with a condition, but have not underwent any medical testing, ask if a test could confirm your diagnosis. Make sure that your doctors are asking you about your condition on each visit, and that you report any symptoms that you are experiencing.
Persistence is so important when you are suffering from serious symptoms affecting your ability to work. Make sure that your doctor understands what you are experiencing, and that her or she is helping you obtain an explanation and treatment for your symptoms. If your condition cannot be explained by a physical condition, also ask your doctor to explore possible psychological causes.
This article was written by Steven Butler. Steven is a partner at Linarducci & Butler, PA and his practice is limited to Social Security Disability/SSI claims. To schedule a consultation with Steven, please use the Linarducci & Butler Contact Form or call 302-613-0707 to schedule an appointment.
