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Disability Evaluation Under Social Security
(Blue Book- June
2006)
This edition of Disability Evaluation Under Social Security, (also
known as the Blue Book), has been specially prepared to provide physicians
and other health professionals with an understanding of the disability programs
administered by the Social Security Administration. It explains how each
program works, and the kinds of information a health professional can furnish
to help ensure sound and prompt decisions on disability claims.
The Adult and Childhood Listings of Impairments
are included in this publication. These listings are just part of how we
decide if someone is disabled. We also consider past work experience, severity
of medical conditions, age, education, and work skills.
This electronic version replaces
the January 2005 and prior editions of Disability Evaluation
Under Social Security. It contains the new listings: Genitourinary Impairments,
effective September 6, 2005, Impairments that Affect Multiple Body Systems,
effective October 31, 2005, and Cardiovascular System, effective April 13, 2006.
SSA Pub. No. 64-039
ICN 468600
June 2006
Our Disability Determination Process
Most Social Security disability claims are initially processed through
a network of local Social Security Administration (SSA) field offices
and State agencies (usually called Disability Determination Services or
DDSs). Subsequent appeals of unfavorable determinations may be decided
in a DDS or by an administrative law judge in SSA’s Office of Hearings
and Appeals.
Social Security representatives in the field offices
usually obtain applications for disability benefits in person, by telephone,
by mail, or by filing online.
The application and related forms ask for a description of the claimant’s
impairment (s), treatment sources, and other information that relates
to the alleged disability. (The "claimant" is the person who
is requesting disability benefits.)
The field office is responsible for verifying non-medical
eligibility requirements, which may include age, employment, marital status,
or Social Security coverage information. The field office then sends the
case to a DDS for evaluation of disability.
The DDSs, which are fully funded by the Federal
Government, are State agencies responsible for developing medical evidence
and rendering the initial determination on whether or not a claimant is
disabled or blind under the law.
Usually, the DDS tries to obtain evidence from
the claimant's own medical sources first. If that evidence is unavailable
or insufficient to make a determination, the DDS will arrange for a
consultative examination (CE) to obtain the additional information needed.
The claimant's treating source is the preferred source for the CE, but the
DDS may obtain the CE from an independent source. After completing its
development of the evidence, trained staff at the DDS makes the initial
disability determination.
Then, the DDS returns the case to the field office
for appropriate action. If the DDS found that the claimant is disabled,
SSA completes any outstanding non-disability development, computes the
benefit amount, and begins paying benefits. If the claimant was found
not to be disabled, the file is kept in the field office in case the claimant
decides to appeal the determination.
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www.socialsecurity.gov
