Overview of Disability
Disability Back Pay
Requirements for Disability
Applications for disability
Tips and Advice for Disability Claims
How long does Disability take?
Winning Disability Benefits
Common Mistakes after a Denial
Mental Disability Benefits
Denials for Disability
Appeals for denied claims
Disability Benefits from SSA
Child Disability Benefits
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
SSDRC authored by Tim Moore
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How does Social Security Decide if I am Disabled?
continued from: If you are denied for disability, is this based on your ability to do your past work?
Whether a claim is being decided at the disability application level, the reconsideration appeal level, or the disability hearing hearing level (where all facts of the case are heard by a federal administrative law judge), the process is the same. All claims undergo a process known as sequential evaluation, in which the claimant's condition is compared to the type of work that they did in the past and is also considered in context with whatever education and skills they possess.
Here is an explanation of the sequential evaluation process used by both disability examiners (at disability determination services, the agency that processes disability claims for the social security administration) and social security ALJs (administrative law judges):
Security Disability and SSI Determinations made under the Sequential Evaluation Process
A) Is the person working and earning a substantial and gainful income at the time they make an application for disability? If they are, their case will be denied. If they are not working at all, or they are working and earning less than the SGA limit, then their case moves on to the next step.
B) Does the person have a severe impairment? Most impairments will be considered severe, simply because most impairments have at least some built-in potential to last at least one full year. However, there are some conditions for which people file claims that can never be considered severe, such as minor sprains and lacerations and seasonal flu. Disability examiners (the individuals who decide claims at the application and reconsideration appeal levels) do encounter claims based on these kinds of trivial allegations and when this happens the case is denied for NSI, or non-severe impairment. Having said this, though, most claims do involve legitimate and severe impairments and, therefore, the case can move on to the next step in the sequential evaluation process.
C) Does the applicant meet or equal a listing in the blue book? A better way of saying this, of course, is "Does the applicant have a condition for which their medical records satisfy the requirements of a blue book listing (for example, there are listings for seizure disorder, conditions of the spine, various forms of heart disease, various forms of cancer, depression, traumatic brain injury, diabetes, vision and hearing loss, skin disorders, etc, etc). If the applicant cannot satisfy a listing requirement, the case moves on to the next level which involves past work.
D) Can the applicant perform their past work work? This determination is made by assessing what the applicant is currently capable of doing, both mentally and physically, and then comparing it to the demands of their relevant past jobs. If the demands of those jobs are greater than what they are currently capable of doing, it will be determined that they cannot return to their past work.
Now, the inevitable question: if an applicant for disability benefits cannot do their past work, will they be approved for disability? And the answer is, maybe. This is because if a person is judged to be unable to do their past work, there is still one more step:
E) Can the applicant who cannot do their past work still do some type of other work?
Other work includes jobs that the applicant's job skills might qualify them for. However, whether or not a person will be considered capable of doing past work will also depend on their age, education, and remaining functional capabilities.
So, to answer the question with which we started is, yes, a denial of disability benefits will involve the consideration of a person's ability to do past work, but the process does not stop there. A person will typically only be approved for disability benefits if it is determined that they cannot do their past work and, in addition to this, they cannot do other jobs that their age and training might otherwise qualify them for. Satisfying this criteria will result in them being found disabled.
Return to: Social Security Disability Resource Center, or read answers to Questions
How does Social Security Decide if I am Disabled?
How Does Social Security Decide How Much I Get For Social Security Disability or SSI?
How Will Social Security Decide a Disability Case that's filed?
Who will decide my Social Security disability claim?
Does Your Doctor Decide If You Get Disability Benefits from Social Security or SSI?
How does Social Security Disability Decide if you can Work or Not?
How does Social Security use Evidence to Decide an SSDI or SSI Disability Claim and Make a Decision?
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