WHO IS ALLOWED TO DECIDE IF YOU ARE DISABLED?

Who is allowed to decide whether you are disabled?  Your doctor?  Your lawyer?  Someone else?

I am speaking of disability from the legal perspective.  

Social Security Rule 96-5p states that the question of whether you are disabled is "reserved to the Commissioner of Social Security."

The claimant cannot say that he/she is disabled.  Your lawyer cannot say.  Your doctor cannot say.  Only the Commissioner can make that determination.

So, how does the Commissioner make that determination?

In the original application process, the determination is usually made by a state agency called the Disability Determination Service (DDS).  The DDS speaks for the Commissioner. 

In the appeal process, the determination is usually made by an administrative law judge (ALJ) following a hearing.  The ALJ speaks for the Commissioner.

I sometimes get clients who tell me, "I know I am disabled because my doctor says I am."  It can be difficult to explain that doctors aren't permitted to make that decision for Social Security.  

So, do doctors have a role in the disability decision-making process?  Yes, they absolutely do.  Doctors should provide two valuable things for a disability claim:  (1) objective medical evidence, and (2) a professional opinion about the patient's residual functional capacity (i.e., restrictions and limitations of function).

Do lawyers have a role?  Yes, they absolutely do.  The role of your lawyer or advocate is to gather evidence and explain to the Commissioner's spokesperson how the claimant meets the guidelines that have been established for determining disability.