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How Social Security Determines If You Are Disabled

  • Published: 2011-06-26 (Revised/Updated 2015-04-19) : Author: Milam Law
  • Synopsis: A list of information The Social Security Administration will consider when hearing your disability claim application.

Quote: "Your RFC is based on all of the evidence about 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."

Main Document

The Social Security Administration uses a complicated process to determine if you are disabled. Here is some of the information they will consider when hearing your claim.

When you apply for Social Security disability benefits from the Social Security Administration (SSA), a complex, five step process is used to determine if you are disabled.

The process involves an examination of the work you did, the skills you learned and if your injuries prevent you from returning to that work or some other type of work.

The agency is interested in your medical condition, age, education, training, and work experience to see if you are able to return to the workforce.

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

How the Process Works

The first three steps are straightforward; if you are working and making more than $1,000 a month, you won't qualify for disability benefits. If your condition is "severe," meaning it interferes with your ability to work, they then move to step three, where if you match a condition on the list, you generally qualify.

If you don't match a condition listed, the SSA will determine if your condition is of equal severity to one that is listed. If they determine it is of equal severity, you generally qualify as disabled. If not, the SSA then moves to step four.

Step Four

Step four is very involved and entails an examination of your previous work history. This is used to create a baseline from which they can determine what capability you had and what remains in your current condition. The SSA takes into consideration what work activities you can do with your medical condition.

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

Your RFC is based on all of the evidence about 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, SSA looks at a great number of factors, such as your ability for sitting, standing, walking, lifting, carrying, pushing and pulling; your ability for reaching, handling large objects, using your fingers, feeling, stooping, balancing, climbing stairs or ladders, kneeling, crouching and crawling.

They 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 and understand, remember and carry out instructions.

Your Work History

The Social Security Administration then looks at the demands of your recent past work and compares them with their assessment of your remaining ability to do basic work activities. They only look at past work that they consider relevant.

What information do they need about your past work? A list of things they consider include:

Main responsibilities of your job(s)

Main tasks you performed

Dates you worked (month and year)

Number of hours a day you worked per week

Rate of pay you received

Tools, machinery and equipment you used

Knowledge, skills and abilities your work required

Extent of supervision you had

Amount of independent judgment you used

Objects you had to lift and carry and how much they weighed

How much you had to sit, stand, walk, climb, stoop, kneel, crouch, crawl, balance

How you used your hands, arms and legs

Speaking, hearing and vision requirements of your job(s)

Environmental conditions of your workplace(s)

And There Is More

There are still more factors they examine in making the determination. As you can see, they will require a very detailed list of information about your condition, abilities and training. Providing this information is absolutely essential to your claim. SSA notes on their website the following:

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.

A Complex Process

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

In this step, the SSA looks at another long list of elements:

If you can adjust to other work

Your age

Your education

Your work experience

Your recent education that may provide you skills you can use

Your age, education and work experience on your remaining capacity for work

In terms of complexity, the application for social security disability benefits is vastly more complex than filing a federal income tax form, but the consequences can be just as severe. If you make a mistake or forget to supply the appropriate information, your claim will be rejected.

For this reason, speaking with an attorney knowledgeable with the Social Security Act, regulations and SSA procedures is very valuable as a way of obtaining your benefits. The process is complex and can be confusing. An attorney can help you understand how to file a claim and assist with the necessary procedures you must follow.

It should be noted that in the discussion of the five steps, the Social Security Administration includes a disclaimer that states:

The following is general information only. The Social Security Act and related regulations, rulings and case law should be used or cited as authority for the Social Security disability programs.

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