November 24, 2014

The Social Security Administration’s Five Step Process

Curious as to how the Social Security Administration (SSA) makes their decision on whether a claimant is disabled or not?  The SSA uses a five-step process, called the “sequential evaluation process,” to evaluate whether claimants’ disabilities are severe enough to prevent them from working.  The steps of the process are as follows:

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  1. Are you working?
    • Yes: If you are working at the time you apply and your earnings are above “substantial gainful activity,” the SSA will find you not disabled.
      • “Substantial gainful activity” means that your gross earnings average more than $1070 a month (or $1800 per month if you are blind), Social Security generally will not consider you disabled.  The amount per month changes from year to year.
      • Note that Social Security is looking only at your earnings, not at your total income.  If you receive money for something other than work activity, like insurance benefits or investment income, Social Security does not consider it at this step.
    • No: If you are not working, or if your gross earnings average less than $1070 per month (or $1800 per month if you are blind), the evaluation proceeds to step two.
  2. Is your medical condition “severe?”
    • Yes: Your medical condition is “severe” under Social Security’s rules if:
      • It is a “medically determinable impairment.”  Typically, you must have a diagnosis from a doctor with medical evidence supporting that diagnosis; an explanation from you of the symptoms you experience is not enough.
      • It meets the duration requirement.  Your condition must have lasted or be expected to last at least twelve consecutive months, or it must be expected to end in death.
      • It significantly limits your physical or mental abilities to do basic work activities.
    • No: If your condition has no more than a minimal effect on your ability to basic work activities, the SSA will find you not disabled.
  3. Does your medical condition meet any of the Listings in the “Listing of Impairments?”
    • Yes: Social Security has a Listing of Impairments describing medical conditions that are considered so severe that they are disabling as defined by law.  If your condition meets or exceeds these requirements, Social Security will find you disabled without proceeding to steps four and five.
    • No: If your medical conditions are not on the list or they do not meet the stringent criteria of the Listings, Social Security proceeds to step four.
  4. Can you do the work you did before?
    • Yes: If the SSA decides that your medical conditions do not prevent you from returning to your “past relevant work,” Social Security will find you not disabled.  Your prior work activity counts as past relevant work if:
      • It was performed within the last fifteen years.
      • You performed it at a level of “substantial gainful activity.”  (See the definition at step one.)
      • You performed it for a long enough time to acquire any skills or abilities you needed to achieve at least average job performance in that occupation.
    • No: If the SSA finds that your conditions prevent you from returning to past relevant work, the evaluation proceeds to step five.
  5. Can you do other types of work?
    • Yes: The SSA will consider the types of limitations your impairments impose on your ability to work.  It will then evaluate these limitations in combination with your age, education, and work experience to determine whether there are any jobs in the economy that you can perform.  If it finds that a substantial number of such jobs exist, the SSA will find that you can adjust to other work, and it will find you not disabled.
    • No: If Social Security cannot identify a significant number of jobs you would be able to perform based on your limitations, age, education, and work experience, it will find you disabled.

For more information, you can look at Social Security’s webpage entitled “How We Make The Decision”.  You can also call the SSA at 1-800-772-1213.  Many claimants find it helpful to seek the advice of a Social Security disability attorney or representative; most offer a free consultation and can help with questions you may have.

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