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Overview of Disability

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Denials for Disability

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Qualifications and How to Qualify

Working and Disability

Disability Awards and Notices

Disability Lawyers, Hiring Attorneys

Social Security List of Conditions

What Social Security considers disabling

Medical Evidence and Disability

Filing for Disability Benefits

Eligibility for Disability Benefits

SSD SSI Definitions



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Will you get a disability award if your condition does not satisfy Criteria in the Social Security Impairment List?




 
Note: the answer to this question appears further down in the approximate middle of this page. The information preceding this relates to the five step process that is used to make decisions on all SSD and SSI claims.

Social Security developed a five-step sequential evaluation process to help them make uniform objective disability determinations across the country. The steps of this evaluation process are as follows:

1. Is the disability applicant performing SGA? (SGA, substantial gainful work activity is work activity that earns a certain amount each month; being unable to earn the SGA amount is part of the definition of disability used by social security).

2. Does the disability applicant have a severe impairment that has prevented them or is expected to prevent them from performing SGA for at least twelve months? (note: there are cases in which individuals are found to have non-severe impairment--for example, a sprained wrist or ankle--and are denied on that basis).

3. Does severity of the impairment meet or equal the criteria of a Social Security impairment listing?

4. If the impairment does not satisfy the disability criteria of a listing in the social security listing of impairments, then do the limitations imposed by the disabling condition prevent all past relevant work? (to learn what "relevant" past work is, visit this link: ).

5. Do their limitations not only preclude all past relevant work but the ability to perform other work in the general economy (other work is mediated by whether or not the person's skills, age, education, and limititations might make it possible for them to perform other types of jobs).

Lets start with the first step of the evaluation process. Social Security must first determine if the disability applicant is perform substantial work activity (SGA), because the Social Security definition of disability requires an applicant to not only have a severe impairment but also be unable to perform work at a substantial level. Social Security must routinely deny disability applicants with significant disabling conditions--even terminal conditions--if they are performing SGA.

The basis of the entire Social Security disability determination process is functional ability; consequently if a disability applicant has the functional ability to perform SGA, they cannot be considered disabled under the provisions of the Social Security Act.

As I stated, this is a sequential evaluation process, so we move to the second step if the disability applicant is not performing SGA due to the limitations of their disabling condition. Step two simply states that Social Security must be able to verify that the applicant's disabling condition is severe (through medical information) and that their condition is expected to prevent, or has prevented, the applicant from performing SGA for at least twelve months.

If the conditions of step two are met, Social Security disability examiners move on to step three. Social Security has a disability guidebook that contains impairment listings for multiple body systems. The impairment listings contain the criteria needed to meet or equal the severity requirements of the individual impairment listings. If the disability applicant meets or equals the criteria of an impairment listing, then the sequential evaluation process ends at step three. At this juncture, they may be medically approved for disability benefits.

Nonetheless, the disability applicant must also meet the non-disability requirements of Social Security disability and/or SSI to actually receive monthly disability benefits.

Will you be Awarded Disability Benefits if you do not satisfy Criteria in the Social Security Impairment List?

This is not a concern for the majority of disability claims that are eventually approved. Satisfying the requirements of a listing is fairly difficult because the approval criteria is extremely specific and very often an individual's medical files will simply not contain the necessary evidence. As a result, most disability applicants will not meet or equal the severity requirements of an impairment listing, even if they have one or more disabling medical conditions of a physical or mental nature.

However, for those who cannot be approved via a social security impairment listing, there are two more steps of the sequential evaluation process.

Note: while the next few paragraphs describe the remaining steps of the SSA evaluation process that allows a claimant to be approved on the basis of not being able to return to a past job, and, further, not being able to switch to some new type of employment, this page will sum up this process of approval as well: Medical vocational allowances are how most disability claims are approved.

The last two steps involve an evaluation of their residual functional capacity and their ability to perform past work or other types of work when their limitations are considered. To do this the disability examiner must first consider all relevant jobs performed in the past fifteen years for three months or more. A relevant job must have involved SGA and the applicant must have had time to learn the job.

If the disability examiner determines that the applicant’s residual functional capacity is so limited that it precludes all of their past relevant work, they (the examiner, or the judge if the case if being decided at a hearing) must move on to the final step.

The final step of the sequential evaluation process is, of course, step five. The disability examiner must take into account the age, education, residual functional capacity, and the transferability of the job skills of the disability applicant to determine if they able to any other kind of work in the general economy. If the disability examiner determines that an applicant is unable to do other work when considering the above criteria, they may approve the disability claim.















Return to:  Social Security Disability Resource Center, or read answers to Questions





























Related pages:


What is the Social Security Disability List of Impairments?
Social Security Disability for insomnia or sleep disorders
Is there a list of conditions that will Qualify you for Disability Benefits?
Filing with SSA for disabled child with autism
The Medical Vocational Allowance Approval
The two criteria used by disability examiners to make a decision on a case
How do you Win Benefits under Social Security Disability or SSI?



Information on the following topics can be found here: Social Security Disability Questions and in these subsections:

Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI


These pages answer some of the most basic questions for individuals who are considering filing a claim.

Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
How to Apply for Disability - What medical conditions can you apply and qualify for?
Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
What happens if I file a disability application and it is denied by a disability examiner or Judge?
How to Prove you are disabled and qualify to win disability benefits
How do you prove your disability case if you have a mental condition or impairment?
Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria