5 step sequential process for social security disability cases

For every single case SSA uses the Five-Step Sequential Evaluation Processto determine whether an applicant is disabled.   The steps are followed in order.    Each step is a question geared to determine the significance and measure of your impairment, as it affects your ability to work full time. If it is determined that the applicant is “disabled” or “not disabled” at any step of the sequential evaluation process, the evaluation will end without going on to the next step.

It is a sequential process, meaning that if at any step you are determined either disabled or not disabled, the process stops and disability is either awarded or denied.

Step 1: Are you working? If you are working, and your earnings averaged more than $1,260 per month last year (during the year 2020), that is considered Substantial Gainful Activity, and Social Security probably won’t consider you to be disabled. Social Security Regulations explain “substantial gainful activity” and whether work activity is not gainful activity, or is done under special conditions or is an unsuccessful work attempt. The “Substantial Gainful Activity” Monthly Earnings Amount for 2021 is $1,310. Social Security averages your income when determining Substantial Gainful Activity.

Step 2: Is your disabling condition severe? Social Security considers a medical condition serious if it has more than a minimal impact on your ability to perform basic work activities. This determination is made by medical evidence only and thus can only be proved by regular treatment with a medical professional. Because of this, routine medical treatment is absolutely essential to your Social Security Disability claim. Your impairments must interfere with basic work-related activities for you to be considered disabled. Your physical and/or mental impairment must be proved  by medical evidence. There is a “duration requirement” that says your impairment(s) must have lasted or be expected to last for a continuous period of at least 12 months, or be expected to result in your death. Your condition is considered “non-severe” if it does not significantly limit your ability to do basic work activities. Simply telling Social Security that you have a bad back or a serious mental health issue will not be enough to get you past step two of the sequential process. You will need the support of a medical professional, documented by medical evidence in his notes and diagnostics like MRIs in order to be successful at this step.

Step 3: Is your condition found in the list of disabling impairments? The problem is that it is very rare to meet a listing of impairments. The example I always give people is amputation. They believe that if they’ve lost an arm or a leg that Social Security will automatically accept them for disability. Unfortunately, that is not the case.  Social Security has a listing of impairments for each of the major body systems. If your disability is described in the listing, that automatically means you are disabled. If your condition is not on the list, Social Security has to decide if it is of equal severity to an impairment on the list. If it is, your claim is approved. If it is not, we go to the next step.

Before step 4 Social Security will ask what is your residual functional capacity to perform work activity? What that means simply is “what are your work restrictions?” It will be absolutely essential at this point of the sequential evaluation process to work with the doctor you’re treating with to have work restrictions assigned. The Social Security Administration will need to know things like how much weight can you lift? How long can you stand? How long can you sit? Can you crouch, crawl, bend, stoop? Do you have problems interacting with people? Do you have problems interacting with supervisors? Do you have issues with attention and concentration either because of a health condition or because of medication side effects? These are all the things that contribute to your residual functional capacity to perform work activity. They are essential for your claim if we are to be successful at steps four and five.

Step 4: Are you able to perform the work you have done in the past 15 years?  Social Security looks at your work you have done in the past 15 years.  If your condition is severe, but not at the same or equal severity as an impairment on the list, then Social Security must determine if your disability interferes with your ability to do the work you did during the last 15 years. If it doesn’t, meaning you can still perform work at one of your old jobs, your claim will be denied. If it does, your claim will be considered further, and we move on to Step 5.

Step 5: Can you do any other type of work considering your age, education and prior work? If you cannot do the work you did in the last 15 years, Social Security looks to see if you can do any other type of work. They consider your age, education, past work experience, and transferable skills, and they review the job demands of occupations that were determined by the Department of Labor in a Dictionary that was last updated in 1991. If you cannot do any other kind of work, your claim will be approved.

To answer the 5 questions, Social Security has to review the reports from all of the doctors, hospitals, and clinics that have treated you. Information about any medication you are taking is also important. The law requires the people at Social Security to consider all of the evidence, and all of your impairments, when they make a disability decision.

Social Security must look at the combined effects of every impairment. It is important to list all impairments you are treating for, not just the major impairments. 

Hiring an experienced attorney will ensure your claim is properly argued. And the best part is any attorney fee is contingent upon the attorney winning your claim. If you need helping applying for Social Security Disability or SSI, please contact me at joshben99@gmail.com. I have over 20 years experience with Social Security Disability cases. 

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