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Evidentiary Requirements for Social Security Disability Benefits

When you file a claim for Social Security disability benefits you will have to meet certain evidentiary requirements before your claim is approved. These evidentiary requirements are set forth by the Social Security Administration (SSA) and involve proof of your medical condition, record of treatment, and in some cases evaluation through a consultative examination.

Medical Evidence for a Social Security Disability Benefits Claim

The main focus of the evidentiary requirements in your Social Security disability benefits claim is that you can provide medical evidence of your disability and its hindrance of your ability to perform substantial gainful activity. Medical evidence should come from an acceptable medical source that provides a diagnosis of an impairing condition, details the severity of the impairment, and provides treatment history for the impairment.

The medical sources considered to be acceptable by the SSA for evidentiary requirements are: 

  • licensed medical or osteopathic physicians;
  • licensed/certified psychologists (for establishing mental impairments);
  • licensed optometrists (for establishing visual impairments);
  • licensed podiatrists (for establishing foot and ankle impairments); and
  • qualified speech-language pathologists (for establishing speech or language impairments). 


Medical Reports for a Social Security Disability Benefits Claim

Your medical reports are the main source of proof of your disability, severity of impairment, and treatment history. The reports need to be made available to the SSA for processing with your Social Security disability benefits claim. Your medical reports should include: 

  • medical history;
  • results of physical or mental examinations;
  • laboratory testing results;
  • diagnosis;
  • a statement describing a medical professionals' assessment of what the claimant can still do despite their impairments;
    • the statement should also describe the claimant's ability to perform work-related activities if they are an adult age 18 or older;
    • for mentally impaired adults the statement should describe their capacity to function in a work setting;
  • a statement describing the claimant's functional limitations compared to unimpaired children their own age if they are under the age of 18; and
  • prescribed treatment plan with response and prognosis. 


Evidentiary Requirements through Consultative Examinations

In some cases when you are applying for Social Security disability benefits your medical evidence and reports may not be enough proof to meet the evidentiary requirements of the SSA. Upon review of your Social Security disability benefits claim the SSA may request a consultative examination and report.

This report should contain the following elements and is preferred to be completed by your treating medical professional.:

  • the claimant's major complaint(s) relating to their condition;
  • a detailed description of the history of the condition;
  • a description and disposition of the pertinent findings based on the history, examination, and tests related to the condition;
  • results of laboratory and other tests;
  • a statement about the claimant's ability to perform work-related activities, and function in a work environment if they are age 18 or older;
  • a statements about the claimant's ability to function at a level compared to non-impaired claimants of their own age if they are under the age of 18; and
  • the consultant's consideration on the claimant's major complaint(s) and any other pertinent information relating to their Social Security disability claim. 


Through all of these types of documentation for evidentiary requirements, you may request the assistance of an experienced Staten Island Social Security Disability lawyer. Your lawyer can assist you in filing your claim, appealing a denial, and help you understand the Social Security disability claim process.

Contacting a Staten Island Social Security Disability Lawyer 

Before you file your Social Security disability claim, be sure to take advantage of this free consumer's guide: 5 Mistakes to Avoid When Filing a Social Security Disability Claim. Contact a
Staten Island Social Security disability lawyer at The Law Offices of Frank J. Dito, Jr. for help in building your disability claim at 800-310-5520.