When you apply for disability benefits, the SSA goes through a lot of work to decide whether you qualify. It’s helpful to understand how they make this decision. Once you have a feel for their thought process, you can tweak the materials you submit to give yourself the best possible chance at success.
What is the 5-step sequential evaluation process?
After you apply for disability, the SSA will decide whether or not they approve your claim. The 5-step sequential evaluation process is what the SSA uses to make a decision about your application. If they deny your application and your case goes to a hearing, the judge will use this same process to make their final decision.
The evaluation process consists of five questions or steps:
Are you working at a substantial gainful level?
Do you have a severe impairment?
Does your disability meet the SSA definition?
Can you do work you’ve done in the past?
Can you do any other types of work?
Your case might not need all five steps. The SSA makes a decision as soon as they can. However, if they need more information, they’ll continue working through the process.
Step 1: Are you working at a substantial gainful level?
The first step in the process looks at substantial gainful activity (SGA). This term describes a level of work activity and earnings that requires you to significantly perform mentally or physically. According to the SSA, if you’re earning more than a set amount of money per month ($1,470 in 2023 for non-blind individuals), you are engaging in substantial gainful activity.
If you are making enough money to engage in substantial gainful activity, the SSA will deny your disability claim. If you aren’t working, or you’re making less money, you have a better chance of getting disability benefits.
Step 2: Do you have a severe impairment?
The next question the SSA asks is whether you have a severe impairment or disability. The SSA will consider not only what condition you have, but how it impacts your life and how long it is projected to last. The impairment must be expected to last longer than 12 months.
Your impairment is considered severe if it significantly limits your ability to perform basic work tasks. The SSA will consider how well you are able to do things like stand, walk, speak, see, hear, lift, and carry. They also account for mental activities like responding to instructions or supervision.
Step 3: Does your disability meet the SSA definition?
At this step, you want your diagnosis to not only be on the list, but to meet the severity required. You’ll need medical evidence that demonstrates your limitations. For instance, if you have epilepsy, your symptoms must fall into one of four categories describing what type of seizures you have; how often they happen; and the physical or mental limitations you have as a result. Your symptoms also must continue to affect you even though you’re being treated.
Step 4: Can you do work you’ve done in the past?
Step four considers whether you could still do work you’ve done in the past. Typically, the DDS looks at any work you have done in the last 15 years and whether you did that work long enough to learn it well.
They also consider your residual functional capacity (RFC) — the most work you could currently do in spite of your limitations. Your medical records will provide the information needed to make this decision.
Step 5: Can you do any other types of work?
The final step in the process determines whether you could do any type of work with your impairment. The SSA will consider your:
Residual functional capacity
To deny your application, the DDS has to come up with three jobs you could theoretically do with your limitations.
A note that if you’re 50 or older, the SSA stops at step 4. As long as you can no longer do the work you used to do, you’ll qualify for benefits. If you’re under 50, the SSA considers your ability to retrain, and to work a different job that’s more suitable to your limitations. In this case, Step 5 matters—and you’ll have to prove there are no jobs you’re capable of working full-time.
How a judge uses the sequential evaluation process
For most people, their initial disability application is denied. You can appeal this decision and go to a hearing. At the hearing, the judge will use this same five-step process to make their decision.
You can get more help by working with a disability lawyer. This is especially important if your case is going to a hearing. While a lawyer is not required, you have a much better chance of winning with a good attorney on your side.
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