Nolos guide to social security disability, ninth edition

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9TH EDITION

Nolo’s Guide to

Social Security
Disability
Getting & Keeping Your Benefits
• Find out if your medical condition qualifies
• Apply for SSDI or SSI benefits
• Estimate your monthly benefits
• Request an appeal hearing and win

David A. Morton III, M.D.

Includes Major Changes to Disability Law


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9th Edition

Nolo’s Guide to
Social Security
Disability

Getting & Keeping Your Benefits

David A. Morton III, M.D.

LAW for ALL


NINTH EDITION

MARCH 2018

Editor

BETHANY LAURENCE

Cover Design

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Names: Morton, David A., 1945- author.
Title: Nolo’s guide to social security disability : getting & keeping your
benefits / David A. Morton III, M.D.
Other titles: Guide to social security disability
Description: 9th edition. | Berkeley, CA : Nolo, 2018. | Includes index.
Identifiers: LCCN 2017043757 (print) | LCCN 2017044726 (ebook) | ISBN
9781413324853 (ebook) | ISBN 9781413324846 (paperbook)
Subjects: LCSH: Disability insurance--United States--Handbooks, manuals, etc.
| Social security--United States--Handbooks, manuals, etc.
Classification: LCC HD7105.25.U6 (ebook) | LCC HD7105.25.U6 M675 2018 (print)
| DDC 368.4/2--dc23
LC record available at />This book covers only United States law, unless it specifically states otherwise.
Copyright © 2001, 2003, 2006, 2008, 2010, 2012, 2014, 2016, and 2018 by David A. Morton.
All rights reserved. The NOLO trademark is registered in the U.S. Patent and Trademark Office.
Printed in the U.S.A.
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Please note
We believe accurate, plain-English legal information should help you solve many of
your own legal problems. But this text is not a substitute for personalized advice
from a knowledgeable lawyer. If you want the help of a trained professional—and
we’ll always point out situations in which we think that’s a good idea—consult an
attorney licensed to practice in your state.


Dedication
To my mother, Mary E. Morton, and to my wife, Mary L. Morton.

Acknowledgments
I would like to thank Nolo founder Ralph “Jake” Warner for seeing the
need for a book on Social Security disability that can be read and used
by ordinary people. I would also like to thank former Nolo editors Robin
Leonard, Steve Elias, and Spencer Sherman for helping to take difficult and
complex areas of law and make them accessible to the general public. Thank
you also to Nolo editors Ilona Bray, Cathy Caputo, Janet Portman, and
Bethany Laurence.


About the Author
David A. Morton has degrees in psychology (B.A.) and medicine (M.D.).
For 14 years, he was a consultant for disability determination to the Social
Security Administration in Arkansas. He was chief medical consultant
for eight years of that time. In that capacity, he hired, trained, supervised,
and evaluated the work of medical doctors and clinical psychologists in
determining mental disability claims. He also supervised medical disability
determinations of physical disorders and personally made determinations of

both physical and mental disorders in adults and children in every specialty
of disability medicine. Since 1983, Dr. Morton has authored several books
on Social Security disability used by attorneys and federal judges.


Table of Contents
Introduction
Your Social Security Disability Companion........................................... 1
Medical and Legal Questions............................................................................................................. 2
Medical Listings.......................................................................................................................................... 3
Quick Disability Determination (QDD)....................................................................................... 5

1

What Is Social Security Disability?.................................................................... 7
A. Two Different Programs................................................................................................................. 8
B. Defining Disabled.............................................................................................................................18
C. Contacting the Social Security Administration.............................................................21
D. Frequently Asked Questions About Social Security Disability.............................22

2

Applying for Disability Benefits.........................................................................27
A. Preparing to Apply...........................................................................................................................28
B. Applying for Disability Benefits...............................................................................................28
C. The Role of Health Care Professionals.................................................................................74
D. How Other Disability Payments May Affect Social Security Benefits.............76
E. Availability and Disclosure of Confidential Records...................................................79
F. Fraud and Other Crimes..............................................................................................................85

3

Disability Benefits for Children..........................................................................87
A. Three Benefit Programs for Children...................................................................................88
B. Applying for SSDI or SSI Benefits............................................................................................90
C. Disability Evaluation....................................................................................................................103
D. Continuing Disability Reviews for SSI Children...........................................................107
E. Other Health Care Concerns.................................................................................................108


4

Getting Benefits During the Application Process (SSI)........111
A. Applying for Presumptive Disability...................................................................................113
B. Impairments Qualifying for Presumptive Disability by Field Office................114
C. Qualifying for Presumptive Disability Through the DDS.......................................116

5

Proving You Are Disabled.......................................................................................119
A. Acceptable Medical Sources.................................................................................................. 120
B. Medical Evidence From Treating Sources....................................................................... 121
C. The Role of Consultative Examinations in Disability Determination.............131
D. Evidence of Symptoms...............................................................................................................134
E. Other Evidence............................................................................................................................... 137
F. Expedited Determinations...................................................................................................... 137

6

Who Decides Your Claim?..................................................................................... 145

A. DDS Basics.........................................................................................................................................146
B. DDS Claims Examiners...............................................................................................................148
C. DDS Organization.........................................................................................................................148
D. Medical Consultants................................................................................................................... 149
E. If Your Claim Is Granted............................................................................................................ 152
F. If Your Claim Is Denied............................................................................................................... 153
G. DDS Corruption and Incompetence................................................................................. 153
H. Quick Disability Determination Unit (QDD)...............................................................163

7

How Claims Are Decided........................................................................................ 165
Step 1. Are You Engaged in Substantial Gainful Activity?..........................................166
Step 2. How Severe Are Your Impairments?.......................................................................166
Step 3. Do You Meet the Listing of Impairments?..........................................................166
Step 4. Can You Do Your Prior Job?.........................................................................................169
Step 5. Can You Do Any Other Job?........................................................................................169


8 Whether You Can Do Some Work: Your RFC................................. 171
A. RFC Analysis for Physical Impairments and Abilities............................................... 173

B. Mental Impairments and Abilities......................................................................................182
C. Claims With Both Physical and Mental RFCs...............................................................185

9 How Age, Education, and Work Experience Matter............... 187
A.Age.........................................................................................................................................................188

B.Education...........................................................................................................................................190
C. Work Experience............................................................................................................................ 193

D. Use of Vocational Analysts......................................................................................................199
E. Vocational Rehabilitation.........................................................................................................201

10 When Benefits Begin.................................................................................................... 203
A. Medical Evidence...........................................................................................................................204

B. Work Experience............................................................................................................................205
C. SSDI or SSI Claimant....................................................................................................................206

11 Reasons You May Be Denied Benefits......................................................209

A. You Earn Too Much Income or Have Too Many Assets........................................ 210
B. Your Disability Won’t Last Long Enough.........................................................................211
C. The SSA Cannot Find You.........................................................................................................211
D. You Refuse to Cooperate...........................................................................................................211
E. You Fail to Follow Prescribed Therapy............................................................................. 212
F. Drug Addiction or Alcoholism Contributes to Your Disability........................ 217
G. You Have Been Convicted of a Crime............................................................................... 219
H. You Commit Fraud.......................................................................................................................220

12 Appealing If Your Claim Is Denied............................................................... 221

A. Deciding Whether to Appeal.................................................................................................222
B. Review the Rationale and Your File From the SSA....................................................226


C. Appeal Basics...................................................................................................................................230
D. Your Right to Representation................................................................................................232
E. Five Levels of Appeal...................................................................................................................233
F. Reopening of Decisions..............................................................................................................286

G. Refiling an Initial Claim..............................................................................................................287

13

Once You Are Approved.........................................................................................289
A. Disability Benefit Payments....................................................................................................291
B. Reporting Changes—SSDI Recipients...............................................................................296
C. Reporting Changes—SSI Recipients...................................................................................308
D. Returning to Work.........................................................................................................................313
E. Passage of the Ticket to Work and Work Incentives Improvement Act.....322
F. Participation in the Ticket to Work Program..............................................................328
G. The Ticket to Hire Program....................................................................................................340

14

Continuing Disability Review............................................................................. 341
A. Frequency of Reviews..................................................................................................................342
B. How the SSA Contacts You....................................................................................................345
C. Medical Improvement Review Standard........................................................................367
D. Children and CDRs.......................................................................................................................377
E. Appealing a CDR Decision.......................................................................................................378

15

Your Right to Representation............................................................................ 379
A. When Do You Need an Authorized Representative?..............................................380
B. What Can an Authorized Representative Do?............................................................381
C. Who Can Be an Authorized Representative?...............................................................382
D. Should Your Authorized Representative Be an Attorney?...................................382
E. How to Find a Disability Attorney......................................................................................383

F. When and How Your Representative Is Paid................................................................384
G. Notifying the SSA of Your Choice for Representative.............................................391
H. Keeping Up on the Law Yourself..........................................................................................391


Appendixes

A Glossary of Bureaucratic Terms...................................................................... 393
B Examples of Technical Rationales for Denials................................ 397
Form SSA-4268 Denials From Initial Application..............................................................398
Form SSA-4268 Denials From Continuing Disability Review (CDR)......................402

C Medical-Vocational Rules........................................................................................413
D How to Use the Medical Listings on Nolo.com............................. 421

List of Files on Nolo.com..................................................................................................................422

Index...........................................................................................................................................................423


Medical Listing Table of Contents
Download the Medical Listings at www.nolo.com/back-of-book/QSS.html

Part 1: Musculoskeletal Disorders and Growth Impairments
A.Definitions............................................................................................................................. 3
B. General Information......................................................................................................10
C. Specific Listings and Residual Functional Capacity.......................................14
Index..............................................................................................................................................33

Part 2: Vision, Balance, Hearing, and Speech

Part I. Vision..................................................................................................................3
A.Definitions............................................................................................................................. 3
B. General Information........................................................................................................ 9
C. Specific Listings and Residual Functional Capacity.......................................10

Part II. Balance Disorders....................................................................................21
A.Definitions...........................................................................................................................21

Part III. Loss of Speech......................................................................................... 23
A.Definitions...........................................................................................................................23
B. General Information and Listing.............................................................................23

Part IV. Hearing Disorders..................................................................................24
A.Definitions...........................................................................................................................24
B. General Information......................................................................................................26
C. Specific Listings and Residual Functional Capacity.......................................28
Index..............................................................................................................................................34


Part 3: Breathing Disorders
A.Definitions............................................................................................................................. 2
B. General Information........................................................................................................ 7
C. Specific Listings and Residual Functional Capacity.......................................11
Index..............................................................................................................................................31

Part 4: Heart and Blood Vessel Diseases
A.Definitions............................................................................................................................. 3
B. General Information......................................................................................................15
C. Specific Listings and Residual Functional Capacity.......................................23
D. Discontinued Listings....................................................................................................45

Index..............................................................................................................................................52

Part 5: Digestive System Diseases
A.Definitions............................................................................................................................. 2
B. General Information......................................................................................................10
C. Specific Listings and Residual Functional Capacity.......................................11
Index..............................................................................................................................................26

Part 6: Kidney Disease
A.Definitions............................................................................................................................. 2
B. General Information........................................................................................................ 6
C. Specific Listings and Residual Functional Capacity......................................... 7
Index..............................................................................................................................................17

Part 7: Blood Diseases
A.Definitions............................................................................................................................. 2
B. General Information........................................................................................................ 6
C. Specific Listings and Residual Functional Capacity......................................... 7
Index..............................................................................................................................................22


Part 8: Skin Diseases
A.Definitions............................................................................................................................. 2
B. General Information........................................................................................................ 5
C. Specific Listings and Residual Functional Capacity......................................... 8
Index..............................................................................................................................................20

Part 9: Hormone Disorders
A.Definitions............................................................................................................................. 3
B. What Is an Endocrine Disorder?................................................................................ 8

C. How Does the SSA Evaluate the Effects of Endocrine Disorders?........... 8
D. Endocrine Listing.............................................................................................................18
E. Discontinued Listings....................................................................................................19
Index..............................................................................................................................................37

Part 10:Multiple Body System Disorders
A.Definitions............................................................................................................................. 2
B. General Information........................................................................................................ 4
C. Specific Listings and Residual Functional Capacity......................................... 5
Index..............................................................................................................................................10

Part 11: Nervous System Disorders
A.Definitions............................................................................................................................. 3
B. General Information......................................................................................................11
C. Repeated Criteria in the Neurological Listings................................................12
D. Specific Listings and Residual Functional Capacity.......................................15
Index..............................................................................................................................................46


Part 12: Mental Disorders
A.Definitions............................................................................................................................. 3
B. General Information—Adult Mental Disorders................................................ 7
C. Specific Listings and Residual Functional Capacity.......................................25
Index..............................................................................................................................................57

Part 13: Cancer
A.Definitions............................................................................................................................. 3
B. General Information........................................................................................................ 9
C. Specific Listings and Residual Functional Capacity.......................................13
Index..............................................................................................................................................54

Part 14: Immune System Disorders
A.Definitions............................................................................................................................. 2
B. General Information......................................................................................................18
C. Specific Listings and Residual Functional Capacity.......................................23
Index..............................................................................................................................................47



Introduction: Your Social
Security Disability Companion
Medical and Legal Questions..................................................................................................................2
Medical Listings...............................................................................................................................................3
Quick Disability Determination (QDD)...........................................................................................5


2  |  NOLO’S GUIDE TO SOCIAL SECURITY DISABILITY

T

his book is about Social Security
disability benefits, which are
provided through a U.S. govern­
ment system run by the Social Security
Administration (SSA). These disability
programs provide cash support for
individuals with mental or physical
disorders (and their dependents, in some
cases) who cannot work because of the
severity of their ­condition. This book is

useful for anyone who:
• is injured or ill and wants to know if
they are eligible for disability benefits
• wants to apply for disability benefits
• is already receiving disability benefits
and wants to know how to protect the
benefits during periodic govern­ment
reviews of their condition
• wants to appeal a decision denying
­disability benefits, or
• is helping an adult or child apply for or
keep current benefits.
The SSA uses two systems to distribute
disability payments:
• Social Security Disability Insurance
(SSDI), for workers who have paid into
the Social Security trust fund (and
their dependents), and
• Supplemental Security Income (SSI),
for d
­ isabled individuals with limited
incomes and assets.
It’s easy to become overwhelmed at
the thought of applying for disability
benefits. The SSA is one of the world’s
largest bureaucracies; its regulations, rules,
operating policies, and guide­lines fill reams

of paper. For example, one chapter of the
SSA’s operating manual is about 20,000

pages long. And much of this information
changes over time.
Still, it is very possible to apply for,
receive, and maintain disability benefits
with the help you will find here. We
recognize, however, that people applying
for disability benefits are most often ill
or injured in a way that makes it difficult
to accomplish the tasks of daily life, let
alone pursue a claim for support from the
government. So you may need help beyond
this book. We have included an entire
chapter on what to do if you need legal
assistance (Chapter 15). Also, throughout
the book we’ve noted situations in which
you may need the advice and s­ upport of
a family member, trusted friend, paid
representative, or attorney.

Medical and Legal Questions
When deciding on your disability claim,
the government considers both legal and
medical issues. Social Security officials
review your claim to decide whether you are
legally entitled to the benefits you request.
They also request and r­ eview medical
opinions on your condition to see if it is
severe enough to make you disabled. The
government considers you disabled only if
you are not able to work in your current or

most recent job and you do not have the
education, experience, or ability to do any
other job. For example, a physically disabled




INTRODUCTION: YOUR SOCIAL SECURITY DISABILITY COMPANION  |  3

60-year-old doctor may have the ability to
work in some other capacity in the medical
industry and could be denied benefits for
that reason. But the same doctor could not
work as a field laborer picking fruit all day
because he would not have the physical
ability necessary for the job.
Chapters 1 through 15 lead you through
the legal and practical issues of applying for
disability payments, appealing if you are
denied, and making sure that you retain
benefits as long as you need them. For most
applicants, it will be useful to read all of
these chapters in the order presented. But
if you have a particular ­issue to research
(for example, you want to file an ­appeal),
you can start with any chapter and you will
be directed to important information in
other parts of the book as needed. Also note
that we occasionally give you references to
the Social Security portions of the Code

of Federal Regulations, or CFR, or to the
federal law, or U.S. Code (U.S.C.).

Medical Listings
Information about the requirements and
functionally disabling aspects of over
200 specific medical problems that make
individuals eligible for disability payments
are available on Nolo’s website (free for
readers of this book) at:
www.nolo.com/back-of-book/QSS.html
These are descriptions of what the SSA calls
the Listing of Impairments.

Go to Nolo’s website and start with the
table of contents for these listings—once
you find the section that matches or most
closely approximates your disability, you
will find all the medical information you
need to determine if your disability meets
the requirements to obtain benefits. For
example, if you suffer from kidney disease,
you would open Part 6 and read through
the listings there until you found a disorder
that matches or is similar to your illness.
Each section of the medical listings
begins with a list of medical definitions
in plain English related to the disorders
discussed in that section. Next, you’ll find
general background information about

the disorders discussed in that section.
Finally, each section lists specific medical
disorders taken from the official Listing
of Impairments the SSA uses in disability
claims. The number before each listing is
the official number the SSA uses to identify
the disability. Following the numbers is a
brief discussion of the meaning and how to
interpret each listing.
These medical listings contain every
listing the SSA has approved for disability
claims. We have revised the SSA’s wording
of the listings to make them more under­
standable. Rest assured, however, that we
made no changes that would compromise
their legal meaning.
Also included in each listing are com­
ments about what the SSA calls residual
functional capacity, or RFC. This is a type
of rating given to a disability claimant who


4  |  NOLO’S GUIDE TO SOCIAL SECURITY DISABILITY




INTRODUCTION: YOUR SOCIAL SECURITY DISABILITY COMPANION  |  5

does not meet the require­ments of a Listing

of Impairment. The RFC says what kind of
work a claimant could do, even considering
his or her impair­ments. If no work is
available anywhere in the United States that
fits into a claimant’s RFC, the claimant may
be approved for disability payments even
though his or her condition does not exactly
fit the listing.

Quick Disability
Determination (QDD)
In 2006, the SSA tried to improve the
dis­ability system by implementing the
“disability service improvement process”
(DSIP)—sometimes simply called “disability
service improvement” (DSI). Most of the
DSIP changes affected the way initial
disability determinations and appeals are
handled. Implementation of this experiment
proved unworkable. In 2010, the SSA
canceled DSIP with one exception: The
Quick Disability Determination (QDD)
process was retained. QDD is a quicker
disability determination process for
those who are obviously disabled (with,
for example, metastatic cancer, severe
blindness, profound intellectual disability
(formerly called mental retardation),

severe kidney failure requiring dialysis,

and the inability to walk—to name a few
possibilities). Favorable decisions will be
made in such cases within 20 days after
the claim is received by the state disability
determination agency (DDS). The average
time is about 12 days. See Chapter 6 for
more information about QDD.

CAUTION
Throughout this book you will see
samples of ­Social Security Administration
forms. These are to help you fill out the actual
forms. But the SSA requires that you obtain
the forms from a Social Security office ­either in
person, by mail, or from the SSA website (www.
ssa.gov). Throughout the book we tell you where
to locate the forms you need.

Get Updates and More Online
When there are important changes to the
information in this book, we’ll post updates
online, on a page dedicated to this book:
www.nolo.com/back-of-book/QSS.html
You’ll find other useful information there,
too, including the Medical Listings, author
blogs, podcasts, and videos.

l

C H A P T E R

What Is Social Security Disability?
A. Two Different Programs.....................................................................................................................8
1. Social Security Disability Insurance..........................................................................................8
2. Supplemental Security Income (SSI)..................................................................................... 15
B. Defining Disabled................................................................................................................................18
1. Inability to Engage in Substantial Gainful Activity........................................................ 19
2. Medically Determinable Impairment................................................................................... 19
3. Duration of Disability....................................................................................................................20
C. Contacting the Social Security Administration................................................................ 21
D. Frequently Asked Questions About Social Security Disability................................22
1. How is the disability determination made?.......................................................................22
2. When do disability benefits start?..........................................................................................23
3. What if I disagree with the determination?.......................................................................23
4. Can I receive disability benefits or payments while getting Medicare or
Medicaid coverage?........................................................................................................................ 24
5. Can I work and still receive disability benefits?...............................................................25
6. How can I receive vocational training services?..............................................................25
7. I understand that to get disability benefits, my disability must
be expected to last at least a year. Does this mean that I must
wait a year before I can get benefits?....................................................................................25
8. I have been receiving Social Security disability benefits for the
past four years and my condition has not improved. Is there a
time limit on Social Security disability benefits?............................................................25
9. I had a serious back injury four years ago and received disability
benefits for about 18 months, until I could return to work.
Unfortunately, my back problems have recurred and I don’t know
how much longer I will continue working. If I reapply for benefits,

will my wait be as long as it was the first time?...............................................................26
10. My brother had an accident at work last year and is now receiving
SSDI disability benefits for himself, his wife, and daughter. Before his
accident, he helped support another daughter by a woman to whom
he has never been married. Is the second child entitled to some
benefits as well?................................................................................................................................26

1


8  |  NOLO’S GUIDE TO SOCIAL SECURITY DISABILITY

T

he Social Security Administration
(SSA) decides who is eligible for
disability payments under rules
established in the Social Security Act by the
U.S. Congress. In this chapter, we describe
the two main SSA ­programs that administer
disability ­payments. We briefly explain
the requirements that any claimant must
meet to r­ eceive benefits. We also provide a
number of tips on how to deal with the SSA
bureaucracy, and include answers to some of
the most frequently asked questions about
Social Security ­disability.

A. Two Different Programs
Once you qualify as disabled under the

­Social Security Act, the SSA makes disability
payments under one of two ­programs:
• Social Security Disability Insurance
(SSDI), for workers who have paid into
the Social Security trust fund (and
their dependents), or
• Supplemental Security Income (SSI),
for disabled individuals with limited
incomes and assets.
SSDI claims are also referred to as Title 2
claims ­because they are authorized under
Title 2 of the Social Security Act. SSI claims
may be referred to as Title 16 claims because
they are authorized under Title 16 of the
Social Security Act. A person claiming
a disability is called a claimant. Some
claimants apply under both Title 2 and Title
16; these are known as concurrent claims.

When the SSA receives your applica­tion,
it will ­determine whether you are eligible for
disability ­benefits under SSDI and/or SSI,
even if you have not ­specifically ­requested
both. This means that if you ­apply only for
SSDI benefits, the SSA will automatically
process your claim for any SSI disability
benefits to which you might be entitled. If
your SSDI claim is turned down, you don’t
have to file another claim for possible SSI
benefits.

1. Social Security Disability Insurance
SSDI provides payments to workers who
have made contributions to the Social
Security trust fund through the Social
Security tax on their earnings. SSDI is
also ­available to certain dependents of
workers. If you are found eligible for SSDI,
you might be ­entitled to retroactive (past)
benefits if you can show that you were
disabled before the date of your application.
(See Chapter 10 for more details on when
benefits begin.)
a. Who Qualifies?

To qualify for SSDI, you must fall into one
of the ­following categories.
i. You are a disabled insured worker under age 66

You must have worked both long enough
and recently enough to qualify. It may not
be sufficient that you worked for many years
and paid Social Security taxes. When you
worked is also important. The law requires