Social Security’s 5 Step Process for Deciding if You Are Disabled
You have been off work and are concerned that you may no longer able to perform your job. Someone has suggested that you apply for Social Security disability and you want to know if you qualify. If you are disabled, you qualify. Sounds simple, yet our Augusta disability attorneys know it’s anything but simple.
A two-paragraph letter from your doctor stating that you are disabled won’t do it. Determining that you are disabled according to the Social Security Administration’s definition requires that an adjudicator review your case following a series of 5 steps known as the “5 step sequential evaluation process.”
Here is a brief summary of what is involved in each step of the process. Keep in mind that many of the terms used to describe the process have very specifically defined meanings that may not be what you expect.
- The first step requires that you prove that you are not currently engaged in substantial gainful activity (SGA.) SGA is determined by looking at your average monthly earnings. For 2016, that figure is $1,130.00. If you are not working, or if your average earnings do not meet or exceed the specified amount, you pass this test and the adjudicator goes on to step 2.
- For the second step, you will need to prove that the reason that you are not engaged in SGA is that you have a “medically determinable physical or mental impairment (or a combination of impairments) that is severe (severe means that your condition interferes with basic work related activities) and the condition has existed or is expected to last for 12 months or is expected to result in death. The adjudicator has a list of activities that are considered basic work related activities. Satisfy the adjudicator at this step then go to step 3. If not then you are not considered disabled and your claim is rejected.
- The third step requires that the adjudicator review your medical information and determine if your impairment is one that is found on “the Listing of Impairments.” The Listing is made up of medical conditions or impairments that the Social Security Administration (SSA) has determined to be “severe enough to prevent an individual from doing any gainful activity.” The fact that you have suffer from one of these impairments is sufficient for a determination that that you are disabled and you qualify for benefits. (This is assuming that you have first met the requirements of steps 1 and 2.)
If your impairment is not on “the Listing,” then the adjudicator is required to make a residual functional capacity assessment (RFC) and decide whether or not you are, despite the limitations and restrictions of your condition, able to engage in full time employment. (8 hours per day, 5 days per week) If, after the assessment, the decision is that you are able to work full time, then you are not disabled and the process ends. If the decision is that you are not able to work full time then go to the next step.
- The fourth step has two parts. The first part requires that the adjudicator review your work history to determine if, according to the residual functional capacity assessment, you should still be able to perform the tasks required for one of your past jobs. If the answer is yes, then you are not disabled, even if your job no longer exists in significant numbers in the national economy.
Part two of step 4 requires the adjudicator to determine whether you have the ability to perform your past work at the same performance level as is now expected in the national economy. If you are found to still be able to perform the tasks required by previous relevant work, then you are not disabled. If you are not able to perform those tasks, go to step 5.
- You have the burden of proof for steps 1 through 4. The adjudicator considers all of the evidence and witness testimony that you provide during each of the first four steps before making a decision. At step 5, the burden of proof shifts to the Social Security Administration. That means that you have proven that you are disabled and entitled to benefits unless the SSA can prove that there are jobs out there that you can learn to do successfully despite your current condition. The adjudicator will, for the first time, consider the limiting effects of your age, education and work experience along with your impairment.
If the SSA is not able to prove its case at this step, then you are disabled.
Don’t be put off by the complexity of the process. Many deserving people don’t get benefits simply because they don’t apply or give up too soon. Our Augusta disability attorneys will be with you through each of the 5 steps. Call us to schedule your free case evaluation today.