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Social Security Disability Blog

5 Step Disability Evaluation Process

Tuesday, November 30, 2010

The Social Security Administration (SSA) uses a five-step sequential evaluation process to determine if any given Claimant is entitled to Social Security Disability benefits. SSA considers each step in this process sequentially before moving onto the next step. In this post, I describe these five steps in their most basic terms.

Step One – Has the Claimant been Unable to Work for 12 Months?

SSA first looks at whether the Claimant has not engaged in substantial gainful activity for at least 12 months. In simpler terms – has the Claimant been out of work for 12 months? If so, move on to step 2. If the Claimant is still working, SSA will not even consider your medical impairments and will deny the claim at step 1. But what about those Claimants who are not working but it has not been 12 months yet? In my experience, SSA will deny the claim at this step. On rare occasions, if there is evidence in the record that the impairment is likely to cause an inability to work of at least 12 months, the SSA may proceed to step 2.

Step Two – Does the Claimant have a Severe Medical Impairment?

The Claimant’s alleged medical conditions must be considered to be a “severe medically determinable impairment.” This is not much of a road block in the evaluation. Most Claimants will have in their medical records some type of diagnostic testing or examination findings that support their doctor’s diagnoses. This will normally be enough to satisfy step 2.

Step Three – Does the Severity of the Claimant’s Impairment Meet the Listings?

The Code of Federal Regulations contains an exhaustive list of medical conditions called the Listing of Impairments (Listings). The Listings contains such impairments as 2.02 Loss of Visual Acuity and 1.04 Disorders of the Spine. Under each listing there is a description of a certain severity of that impairment. For instance, for loss of visual acuity — the Claimant meets the listing if the corrected vision in the Claimant’s best eye is 20/200 or worse. If the medical records show that level of severity the Claimant is entitled to disability benefits at step 3. Please note that the level of severity described in the Listing of Impairments describes only the most seriously disabled of Claimants. Most Claimants do not meet the Listings and SSA proceeds to step 4.

Step Four – Can the Claimant Perform Their Past Relevant Work?

If the Claimant can still perform their past relevant work — they are not entitled to disability benefits. The Claimant’s past relevant work is work that has been done in the last 15 years. SSA will examine all of the jobs the Claimant has had over the past 15 years and categorize them as sedentary, light, medium or heavy work. These categories describe, in general terms, the physical requirements of the jobs. For instance, in a sedentary job, the Claimant would not be required to lift more than 10 pounds.

The SSA will then determine the Claimant’s residual functional capacity (RFC). The RFC is a description of what types of things the Claimant can still do despite his or her impairment. One element of the RFC is often how much weight the Claimant can still lift. If the Claimant can lift no more than 10 pounds, his RFC will be at most sedentary. If the Claimant has prior work at the sedentary level and has an RFC for sedentary work — the Claimant is not entitled to benefits. If the Claimant’s RFC is less than all the Claimant’s past relevant work — SSA proceeds to step 5.

Step Five – Can the Claimant Perform Other Work?

In this final step, the question is whether there are any other types of jobs, besides the ones the Claimant has performed int he past, which the Claimant can do. SSA performs its analysis by examining the Claimant’s RFC in conjunction with his or her age, education and skills to determine if there are any other types of jobs the Claimant can still do. Note that the analysis here is whether such jobs exist – not whether the Claimant could actually get hired. If there are no other types of jobs the Claimant could do, the Claimant is granted disability benefits at Step 5.

By David Galinis

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