Everyone who applies for Social Security Disability Insurance or Supplemental Security Income must pass a five-step sequential evaluation to measure their disability. It’s a rigorous process that results in denials over half of the time.
According to the Social Security Administration (SSA), one in every three applications for disability benefits is approved on the first try. An additional 20 percent of applicants receive benefits at the reconsideration and hearing levels.
Understanding the five-step sequential evaluation can help your disability attorney prepare a strong case and identify factors that could cause a denial. Here’s what the Alabama Disability Determination Service (DDS) looks for when evaluating applications.
Step 1: Financial Eligibility
If you’re making money through a substantial gainful activity (SGA), the Social Security Administration does not believe that you’re disabled. To pass the first step, you must earn less than $1,180 per month which is the SGA amount for 2018 for non-blind individuals and less than $1,970 per month for statutorily blind individuals. Therefore, if you earn more than the SGA level, even if you have an impairment that meets the requirements for disability, you won’t qualify for Social Security disability benefits.
Step 2: Severe Impairment
Next, you must show the SSA that you have a severe physical or mental disability. Multiple minor impairments may also qualify if combined significantly limit the work you could do. The disability must prevent you from working for at least 12 consecutive months. This decision is based on medical opinions and exams conducted by your doctor and the SSA.
Some people have severe impairments but are still able to perform daily activities of living and work without any restrictions because their impairments are controlled with the use of drugs. For example, if you have severe diabetes but it is controlled by insulin, your impairment would be considered “not severe.”
Therefore, your claim will be denied if your impairments (individually or combined) are not severe, do not significantly limit the work you can do, and can be controlled with drugs prescribed by your treating physician.
However, if your impairments are considered severe, then the analysis proceeds to step 3.
Step 3: Impairment Criteria
If you pass the first two steps, the SSA will review your medical records to determine whether your disability matches one of the many conditions included in the Listing of Impairments. Even if your disability isn’t listed, you may still qualify through an equivalent condition. This step determines your medical eligibility.
Step 4: Previous Employment
Can you still perform your previous job? If so, the SSA will deny your claim and say that you’re not disabled. A doctor will measure your capabilities on a residual functional capacity (RFC) form that quantifies your ability to sit, stand, lift, communicate and complete various on-the-job tasks. The answers are compared to the activities associated with jobs that you’ve held in the past 15 years.
Step 5: Work Capacity
If you’ve passed the first four steps, the RFC results determine if you’re able to perform another type of employment. A final medical-vocational assessment measures your ability to obtain and perform other work based on your age, career experience, education and gender.
Submitting an SSI or SSDI Application
Even if you meet the criteria outlined in the five steps of the sequential evaluation, the process of applying for SSI or SSDI benefits is stressful, frustrating and time consuming. If you’re worried about the application process or if you’re appealing a medical or technical denial, an attorney can prepare a robust application that might help the DDS reach a fair decision.
If you’re disabled and struggling to support your family, contact the Social Security disability lawyers at Allums Welsch, PC to schedule a free initial consultation at our office in downtown Bessemer. Our compassionate attorneys and office staff will help you fight for the financial assistance that you need.