What Are The Steps in The Social Security Disability Determination Process?

Have you ever wondered what the process is for the review and approval of SSD benefits from the Social Security Administration? Learn about Social Security Determinations in this post.

When an applicant applies for Social Security disability benefits, the Social Security Administration (SSA) has to figure out whether the person’s disability is severe enough to qualify him or her for benefits. To help with this determination, the SSA uses a five-step process in order to decide whether an applicant meets this standard of disability.

While the SSA only uses five steps to make its Social Security disability determination, it is important to note that this process is not simple. The SSA will ultimately evaluate a number of factors relating to the applicant’s life, so it is useful for potential applicants to understand how their disability may be evaluated.

The SSA’s Five Steps

1. Is the applicant working?

First and foremost, the SSA must determine whether an individual is working and whether that person is working at a level above what the SSA believes a truly disabled person can accomplish. The SSA uses a level called substantial gainful activity (SGA) limit to make its disability determinations.

While applicants are still allowed to work a small amount when they apply for and start collecting disability benefits, the income the applicant earns cannot exceed the SGA limit, which is the equivalent of $1,090 per month. The applicant cannot earn above the SGA limit because income shows a person’s ability to work, and if an applicant earns more than this amount per month, the SSA believes he or she is not severely disabled enough to qualify for disability benefits.

2. Is the applicant’s condition “severe”?

Second, the SSA will determine the severity of the applicant’s impairments. While the presence of impairments is important, what matters most is the effect of the applicant’s impairments on his or her ability to function mentally and physically. The severity of medical conditions can range anywhere from not severe to incapacitating.

The claim examiner assigned to an applicant’s case will determine whether the applicant’s impairment significantly limits the work that person can perform. If none of an applicant’s impairments are considered sufficiently severe, the applicant’s claim will be denied. If the applicant’s impairments are determined to be severe, the application then proceeds to the next step.

3. Is the applicant’s condition found in the SSA’s list of disabling conditions?

Third, the examiner will compare the applicant’s disability to the SSA’s official list – known as the Listing of Impairments – to determine if the applicant’s impairments are equal to or more severe than the SSA’s requirements. Each listed impairment specifies a level of medical severity that is required for an applicant to be considered disabled.

If an applicant’s impairment is not on the list, the examiner will still consider the impairment, but has to determine if it has a listed equivalent that is of the same severity. If the examiner finds that an applicant’s condition meets or surpasses the requisite severity, it will be presumed that the applicant cannot complete any substantial work and the process continues.

4. Can the applicant do the work he or she did previously?

Fourth, after finding that an applicant’s condition equals or exceeds any listed impairment, the examiner considers whether the applicant can still perform work he or she has done in the past despite the impairment.

To make this assessment, the examiner considers the applicant’s residual functional capacity – or rather how much ability the applicant has despite his or her medical conditions. If the examiner determines the applicant can perform past work, the applicant’s claim will be denied on the theory that the he or she can return to the prior line of work.

5. Can the applicant do any other type of work?

Lastly, after finding that an applicant cannot perform past work, the examiner will evaluate whether or not there are other jobs available that the applicant can perform despite his or her limitations. It is possible that even though a person cannot perform the work that they used to do that they can do other less physically or mentally demanding work instead.

It is important to remember at this stage that all the SSA has to do is prove that there are jobs out in the world that the applicant is capable of performing – the SSA does not find the applicant a job to perform. If the examiner believes an applicant cannot perform past or any other type of work, the applicant will finally be given disability benefits.

If you are applying for benefits consider Attorney Neil H. Good’s firm for legal representation. For a free case evaluation, contact our office online or call #(847) 577-4476.