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The Steps of The Social Security Disability Determination Process




 
Social Security uses the same medical determination process for both SSI and SSD. The evaluation process is known as the five-step sequential evaluation process.

The five steps used in the sequential evaluation process are:

Step 1 - Social Security must determine 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 individualís 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 individualís 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 individualís 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.








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








Related pages:

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?



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