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Social Security Disability Determination Process

Author: Dallas W. Hartman P.C.

Published: 2011-08-14

Synopsis and Key Points:

When you apply for Social Security disability insurance SSDI benefits from Social Security the agency uses a process to determine whether you are disabled.

Main Digest

The Social Security Administration uses a five-step process to determine whether you are disabled.

When you apply for Social Security disability insurance (SSDI) benefits from the Social Security Administration (SSA), the agency uses a five-step process to determine whether you are disabled.

During the SSDI Application process, the SSA examines the work you did previously, the skills you have acquired and whether your injuries prevent you from continuing that type of work.

If you can't return to your previous line of work, they evaluate your medical condition, age, education, training, and other work experience to see if there is some other kind of work you may be able to do.

The Five-Step Process:

Step One: Are you working

Step Two: Is your condition "severe"

Step Three: Is your condition found in the list of disabling conditions

Step Four: Can you do the work you did previously

Step Five: Can you do any other type of work

The first three steps are clear; if you are working and earn more than a $1,000 a month, you're not disabled.

If your condition is "severe," which for SSA means it interferes with your ability to work, they then move to step three, where if your condition matches a condition on their list, you will generally qualify for a disability benefit.

If yours doesn't match the conditions listed, the assessment becomes more complex. The SSA then compares your medical condition to determine if it is of equal severity to one of the listed conditions.

If they determine it is of equal severity, you generally qualify as disabled. If not, the SSA then moves to step four.

Step four is an examination of your previous work history. They use this step to determine what work you previously could do and what remains of that ability in your current condition.

Residual Functional Capacity

If you are determined to have a medical condition that affects your ability to perform work as you have previously, but is not as severe as any impairment described in the Listing of Impairments, they assess your "residual functional capacity" (RFC).

Your RFC is based on all of the evidence assessed regarding your condition and used to determine what you can still do, despite any limitations caused by your impairment and related symptoms, such as pain and fatigue.

To decide whether you can do your past work, the SSA considers many factors, such as your ability for sitting, standing, walking, lifting, carrying, pushing, pulling; your ability for reaching, handling large objects, using your fingers, feeling, stooping, balancing, climbing stairs or ladders, kneeling, crouching, crawling.

They also consider environmental conditions, such as temperature extremes, wetness, humidity, noise, hazardous working conditions like moving machinery or heights, dust, fumes, odors, gases, poor ventilation, vibrations.

Other general factors include your ability to see, hear, speak, maintain concentration and attention at work, understand, remember and carry out instructions.

Your Work History

The SSA then evaluates the demands of your recent past work and compares them with their assessment of your remaining ability to do basic work activities. They only examine past work that they consider relevant.

What information does the SSA consider in regard to past work? The issues they consider include:

Additional Factors

There are still more factors that the SSA examines in making the determination. They require a very detailed list of information about your condition, abilities and training. Providing accurate and complete information is crucial for your claim. SSA notes the following on their website:

"It is your responsibility to see that we get the information we need to determine whether you are disabled. If you do not provide the information we need about your medical condition(s) and your work history, we will deny your claim for disability."

If, after all the questions in step four, the SSA determines you cannot perform your previous type of work, they then move to step five, which decides whether you can still do some other type of work.

The Final Step

Finally, the SSA evaluates additional factors in light of the analysis completed in the first steps:

Obtaining Necessary Assistance

It is important to note that no part of this process is simple. There are few true/false, yes/no questions on this application. The more fully you can explain each part, with supporting documentation, the higher the chance you will have at being approved for disability benefits.

This process requires the assembly of a complex personal set of documents. The potential for making a mistake in this assembly is great, and the consequences of any mistakes are equally great. Any mistakes or omissions may delay the receipt of disability benefits by months or years, and force you into the appeals process if you do not adequately support your claim.

An attorney who is versed in the ways of the Social Security Act, the thousands of supporting regulations and SSA procedures can make this challenging process manageable and successful. An experienced attorney can help you understand how to file a claim, help to ensure the application is complete and appropriately documented, and assist with any problems that may occur along the way.

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