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Recent ruling clarifies criteria for evaluating illnesses

A relatively recent ruling by the Social Security Administration has clarified how the administration and its adjudicative staff will decide whether a particular illness will qualify a New Jersey applicant for disability benefits.

One of the main objectives of the ruling is to clarify that, when evaluating a claim, it is not the administration's goal to assess an applicant's "credibility" in the sense that the administration is trying to decide whether or not an applicant can be believed. The goal is instead to determine whether or not there is enough evidence of an actual disabling condition so as to warrant the payment of disability benefits.

The ruling also clarified that the administration and its officials will use a two-step process when evaluating whether an illness or medical condition meets the administration's criteria for awarding disability payments. The administration will first examine what it calls "objective" medical evidence, like charts and tests, to determine whether an illness is in fact a "disability."

If the administration, after looking at the objective evidence, determines that it could declare someone disabled based on that evidence alone, then the administration will move forward and determine if the applicant otherwise qualifies for benefits. Otherwise, the administration will allow an applicant to make his or her case using non-objective evidence like a personal narrative or testimony from friends and loved ones.

Residents of Newark should be aware that this recent ruling is not a change in the law but some additional clarifying guidelines on how the administration will interpret existing law. Still, this ruling is likely to be used by important officials in the Social Security Administration, meaning that it can impact how cases get decided.

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