Regardless of whether you are applying for SSDI and/or SSI benefits, Social Security uses a 5-step sequential process to determine whether an applicant qualifies for Social Security Disability benefits.
First, it may be beneficial to go over the differences between SSDI and SSI and how they pertain to you.
Step 1 - Are you working?
The Social Security Administration looks at whether or not you have Substantial Gainful Activity (SGA) which is defined in 2020 as earning of $1,260.00 per month. For blind applicants, SGA is defined as earning $2,110.00 per month. The general rule is that if you are earning $1,260.00 per month, you are not disabled and SSA’s review of your application stops at this point.
There are few exceptions to this rule. If you are working and earning less than $1,260.00, or $2,110.00 if you are blind, your case will move forward to Step 2 of the analysis, however your chance of receiving benefits is far less likely.
Step 2 – Is your condition severe?
In order to be found disabled you must have a medically determinable physical or mental impairment, or combination of impairments, which are severe. Severity is determined by how the condition(s) interferes with your ability to perform basic work activities. The duration of the severe condition must have lasted 12-months, be expected to last 12-months or result in death. You must meet both the severity and duration requirements to move onto the next step.
Step 3 – Does your condition meet the severity of a Listing?
Social Security maintains medical criteria in a listing, in order to determine the severity of an applicant’s condition. There are Listings for physical and mental health conditions which include very specific, detailed and stringent criteria that must be met primarily through an analysis of the available medical records, with little reliance on an applicant’s subjective complaints or anecdotal history.
If you meet or equal the severity of a Listing and your condition also meets the duration requirement defined in Step 2, you are determined to be disabled. It is likely that you will not be found disabled at Step 3. If that is the case, the medical reviewer handling your case will develop an x capacity (residual functional capacity (RFC)) which defines how they feel your condition limits your ability to perform work activities. Your case will then move onto Step 4 where the RFC will be utilized to determine your ability to perform work.
Step 4 – Can you perform your past relevant work?
Past relevant work (PRW) includes the work you have done in the last 15-years which you performed at Substantial gainful activity (SGA) and for a long enough period to have learned how to do the job. If it is determined that you have the residual functional capacity to physically and mentally perform your past relevant work, you are not disabled. If it is determined that you are unable to perform past relevant work or there are questions regarding your ability to perform your past relevant work, the case moves to the final step of analysis.
Step 5 - Can you make an adjustment to perform work other than your past relevant work?
During this final step, the reviewer will consider your age, education, vocational history and residual functional capacity to determine if you can perform other work. The older you are, the less educated, the longer you have performed the same type of work and the more physically demanding your past relevant work was, are all factors that are considered in this step. If you are between the ages of 18-49, and have a high school diploma, the chances of getting disability benefits during the initial application process are very unlikely. The burden of proof that Social Security needs to meet in order to show you can adjust to and perform other work is minimal. If you are between the ages of 50-54, your chances improve slightly but not significantly.
If you are in need of an SSDI attorney at any crucial step of the social security disability process, please contact Linay Haubert R.N., Esq of the Doylestown office of High Swartz law firm at 215-345-8888.