Claims are frequently denied because the judge determines that the claimant’s impairment is “not severe”.
Assessment of severity of an impairment is Step 2 in the 5-Step Sequential Evaluation.
Here is a diagram that illustrates the 5-Step Sequential Evaluation:
*This is contained in teaching materials prepared by the Social Security Administration.
The Social Security Administration has its own definition of “severe”:
An impairment is severe if the symptoms cause a limitation or restriction having more than a minimal effect on an individual's ability to do basic work activities.
This determination will be based on the medical records as well as the function reports completed by the claimant and others in the Social Security claim process.
What does the judge look at in my medical records and function reports?
The judge (or adjudicator) will look at:
How you describe your symptoms to your doctors
What aggravates your symptoms (and sends you to the ER or the doctor’s office)
What relieves your symptoms
What you say you can still do despite your symptoms
What you say you cannot do
Whether you followed your doctor’s advice (if you stop treatment before your doctor wanted you to, your condition must not be very severe)
In many cases, judges find that symptoms are not severe because the claimant can still carry on a fairly normal life, doing household chores, cooking, shopping, mowing the yard, driving, taking part in family events, staying active in social groups, taking vacations, and enjoying hobbies.
What you say and how you say it when you see your doctor or therapist can have a major impact on your case.
For more insight into communicating with your doctors, see these earlier blog posts on how to be an active member of your medical team and how not to sabotage your case. As a Southern Illinois Social Security attorney, I have witnessed first-hand the consequences that come as a result of clients being careless with their claims.
The next posts in this series will address these common ways claims get denied when they could be approved:
3. The claimant’s allegations of pain are not properly evaluated.
4. The claimant does not have sufficient evidence to prove their impairment.
Many claimants make the mistake of thinking the Social Security Disability claim is a simple process, so they go all the way through the process and attend their hearing without a Southern Illinois Social Security Disability representative. Many are shocked when they receive a denial based on the ALJ’s finding that their impairments do not limit or restrict their ability to function enough to qualify them for benefits. Then they have to decide whether to appeal or start a new claim. See part 1 in this series about the common reasons claims get denied and this earlier blog article about how many claims get denied at the hearing level.
Even though it is a “non-adversarial” hearing and the Agency has some responsibility to help develop the record, it is the claimant’s job to build a record that supports a favorable decision. Most claimants need the experienced, dedicated representation of a Southern Illinois Disability attorney to accomplish that.
Joni Beth Bailey is a Southern Illinois Social Security Disability attorney.