If the claim does not meet listing, then the DDS doctor determines whether there are multiple conditions that will “equal” a listing. This is most common in claims for disability from a multisystem disease such as diabetes. The claimant may not have eye disease or peripheral neuropathy that qualifies on its own. But, if they can’t walk without tripping because they can’t feel their feet and they can’t see the floor, then the two problems together equal the listing for diabetes with peripheral neuropathy, and the claimant is disabled.

If the claims do not meet or equal one of the listings, then the DDS doctor must form an opinion about the claimant’s “Residual Functional Capacity.” This is how most SSA disability claims are decided. DDS determines whether the claimant is able to do a job in the national economy. Unlike many private insurance systems, this is not based on whether the person can go back to his or her previous job. The question is whether the person can do any job.

Taking all the medical problems and allegations into consideration, the DDS doctor rates impairments on a specific form. The ratings include how much weight can be lifted, how far and how long can the person walk, how long can they sit, can they operate foot pedals and hand controls, can they climb, can they crawl, can they squat, etc. It also requires rating of impairments in use of the hands and arms, vision, communication (both hearing and speech), and environmental limitations such as heat, cold, or dust. This list of limitations is then compared to the work the person has done in the past and any related work the person might do. If they are so limited that they can’t do any regular job, then they qualify for disability.

This is the area where the personal physician can be of the most help to disabled patients. Too many doctors write letters that say, “John Doe has spinal stenosis and is totally and permanently disabled.” The diagnosis is clear but the rest of the statement will be ignored by DDS. Under the law, it is the Commissioner of the Social Security Administration who decides whether the person is disabled.

On the other hand, if the treating source opinion (the attending physician’s notes) gives specific limitations, these must be given careful consideration. The statement that “John Doe has spinal stenosis and cannot lift more than 10 pounds or walk more than 100 feet or sit for more than 20 minutes without changing position” will probably get Mr. Doe his SSA disability benefits promptly.