How are Social Security Disability cases decided? - the Process Social Security Uses In Every Disability Case

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If an individual is working over the monthly
SGA earnings amount (each year Social Security determines an amount of monthly earned income that it considers to be substantial gainful activity) with no special conditions given by their employer to enable them to perform their work, their claim will be denied for SGA performance and the sequential evaluation process ends there.

If an individual has performed work since their alleged onset that is under the monthly SGA amount, or they have not worked since the alleged onset of disability, the sequential evaluation process moves to step 2.

2. Does the individual have a severe impairment? Social Security considers any medically determinable mental or physical impairment to be severe if it has already prevented an individual from performing SGA for twelve months; or it is expected to prevent them from performing SGA for twelve continuous months; or the condition will result in death.

If Social Security determines there is a severe medical impairment, the sequential evaluation process moves to step 3.

3. Does the individual's impairment meet or equal the disability criteria of a Social Security impairment listing? All impairment listings and their criteria are contained in the Social Security Disability evaluation book, "Disability Evaluation Under Social Security".

If an individual meets or equals the impairment listing criteria (for a certain condition; for example, depression, or arthritis), their disability claim will be approved for disability benefits at this level. If their impairment does not meet or equal the criteria of an impairment listing, the sequential evaluation process moves to step 4.

4. Can their individual return to past relevant work? Relevant past work is any work that A) an individual performed for three months or longer, B) that they had time to learn and C) in which they earned the SGA amount or more in the past fifteen years. If an individual cannot return to even the least of these jobs, the sequential evaluation process moves to step 5.

5. Can the individual perform other work? Other work is any other type of work that is performed in the general national economy that an individual might be able to perform when their age, education, residual functional capacity, and transferability of job skills is considered (note: generally, Social Security considers individuals who are over the age of 55 not to be re-trainable for other types of work).

If an individual is unable to perform any of their past work, or any other work, as it is performed in the national economy, they may be approved for Social Security Disability.

Social Security uses the five step sequential evaluation process to make all of their disability determinations, whether the claim is for a mental or physical condition, or whether it is filed under the SSI or SSD program. This, of course, is what makes the Social Security Disability process uniform nationwide.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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