One of the arguments for disability you can use when pursuing SSDI or SSI benefits is called the functional capacity argument. To win using this argument, you will need to prove to Social Security that your capacity to work has been so reduced by your medical conditions that you would not be a reliable full time employee at any type of job.
This functional capacity argument is the most common theory of disability accepted by judges at disability hearings. This is because many, but not all, listing level cases are approved at the initial application or reconsideration appeal stages. Social Security adjudicators can often spot listing level cases because the medical record in those cases clearly points to one major problem. There is no question, for example, that a person whose heart is working at 10% would be disabled per Listing 4.02 – chronic heart failure.
By contrast, if you suffer from multiple medical problems you would likely not be approved at the initial application stage because:
no one condition reaches listing level (although in combination these conditions would likely be disabling); or
your claims file contains medical records from numerous medical providers and the adjudicator does not have the time or experience to read and fully understand your record
Our experience has been that Social Security adjudicators simply do not have the training, expertise or time to evaluate long and complicated medical records and to reach a conclusion that the patient/claimant is disabled.
A disability judge, however, would hopefully have the training and expertise to recognize that the combined effect of multiple severe medical problems would make it impossible for you to work in a reliable manner. This is where the functional capacity argument comes in – we are arguing that your ability to function at any job has been so reduced by your combined medical issues that you are therefore disabled.
Not only are judges better trained than adjudicators, but when you reach a hearing you have the advantage of having an attorney to clarify the record, highlight important pages, and advocate for you.
So, if you have been denied at the initial and/or reconsideration appeal, do not give up. Many deserving claims are not approved mainly because the evidentiary record is complex. If you find yourself in this situation, please reach out to us for help.