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The Role of Health Care Providers and School Officials in The Disability Claim Process

April 19, 2020

When children are applying for disability benefits, it is helpful for health and school professionals to know the Social Security disability determination process. Importantly, how central it is for timely and complete submission of medical evidence, school records, and other pertinent information in the process of evaluation of Social Security disability claims.

Assessment of Disability claims, or Title II claims, use evidentiary requirements and the Listing of Impairments for each body system. The Social Security Administration determines how disability is defined for all individuals, as the inability to participate in any substantial gainful activity (SGA) due to any medically determined, physical or mental impairment(s), expected to result in death or which can be anticipated to last for a continuous period of not less than 12 months.

For children who are applying for Title XVI, or Supplemental Security Income, the definition of disability differs from the general definition of disability for Title II claims (see above). Under Title XVI claims, a child who is under 18 is considered disabled if there exists a medical diagnosis, be it a physical or mental impairment or combination, causing marked and severe functional limitations, which are expected to cause death or last at least 12 months.

The State Disability Determination Services (DDS) will also request consultative examinations when reviewing adult and children's disability claims.

Professional Relations Officers, listed by state, are helpful to speak with as well. You may want to speak to an Officer to answer questions involving consultative examinations, and reviewing disability claims for DDS in your area. They can also help you with signing on to Social Security's Electronic Records Express website and uploading school or health related records pertaining to a disability claim. You are also able to fax records to the state DDS or Social Security Agency. This information can be found in the letter you received when the medical evidence was requested of you.

This blog is intended for information purposes only and does not establish legal representation or financial guidance.