The Steps of The Social Security Disability Determination Process

Social Security uses the same medical determination process for both if an individual is working and if they are still working are the working at the SGA limit or over. SGA or substantial gainful activity is a monetary amount of earnings the Social Security sets each year as a self-supporting wage amount.

If an individual is working at the SGA limit or above, their disability claim will be denied prior to being sent for a disability medical decision. It does not matter what their disabling condition or conditions are -- as long as they are earning over the SGA limit with no help from their employer their disability claim will be denied (special help means that special considerations are given to help the individual keep the job).

Step 2 - If an individual is not working at the SGA work level, then their allegation of disability must be evaluated. They must have a medically determinable impairment, which can be physical or mental, that is documented by medically acceptable clinical and/or diagnostic techniques and which is considered to be severe versus non-severe. Signs, symptoms, and lab findings (if applicable) must always document a physical or mental impairment; consequently an individual must make it past this hurdle although there are a few who do not. If they do not, their disability claim will be denied.

Step 3 - Social Security must determine if an individual's medically determinable mental impairment or physical impairment meets or equals the listing criteria of a Social Security medical impairment listing (listings are in the blue book, which is often called the Social Security Disability list of impairments).

If an individual does meet or equal the severity requirements of an impairment listing, the disability claim will be approved for disability at this level. If not, they must go to levels four and five that deal with their ability to perform work activity when you consider their residual functional capacity (what they are able to do in spite of the limitations of their disabling condition or conditions).

Step 4- Can an individual perform any of their past relevant work? It is relevant if it is any job they performed in the past fifteen years for three months or more, prior to filing for disability, in which the person had time to learn the job, and had SGA level earnings while doing the job.

If their residual functional capacity precludes any of their past work activity, they still have to be evaluated to determine if they could do any other kind of work when their limitations are taken into consideration.

Step 5- Can an individual perform any other kind of work when their residual functional capacity, education, age, and work history are considered? If the individual's residual functional capacity is restrictive and their job skills do not transfer to any other kind of work, they may qualify for an approval for disability benefits through a medical vocational allowance. This type of allowance is based upon an individual's residual functional capacity, transferability of their skills, their age, and their education.

The sequential evaluation process ensures that all disability claimants have an equal chance of being medically approved for disability benefits because the evaluation is done with no regard to which disability program an individual is filing for.

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.

Most popular topics on

Social Security Disability in North Carolina

Common Mistakes to avoid after being denied for Disability

Tips to Prepare for Filing for Social Security Disability or SSI

Advice to Win SSD and SSI Benefit Claims

Social Security Disability SSI Questions

What is the difference between Social Security Disability and SSI?

How to get disability for depression

Getting disability for fibromyalgia

SSI disability for children with ADHD

What is the Application Process for Social Security Disability and SSI?

Social Security Disability SSI Exam tips

More Social Security Disability SSI Questions

What makes you eligible for Social Security Disability or SSI?

Related pages:

Should I get a disability lawyer in North Carolina?
The Steps of The Social Security Disability Determination Process
How is the Determination for Disability made by Social Security?
Appealing A Social Security Disability Determination
Who makes the Determination of a Social Security Disability Claim?
Getting a Social Security Disability Determination After Seeing a Psychologist at a Mental Evaluation
Disability determination services in North Carolina
How does the North Carolina Social Security Disability determination process work?
Why does a Veteran's Spouse lose SSI after a service connected disability is approved?
Can a disability lawyer charge an hourly fee for helping to file the claim?
If you apply for disability in Maryland
Will I qualify for disability benefits in Maryland?
Getting a Disability Lawyer in Maryland