5 Step Process SSA Uses to Determine Disability Eligibility

5 Step Process SSA Uses to Determine Disability Eligibility

Suffering from an injury? Or, an illness that greatly impacts the quality of your life due to the severity of your condition? Not only can it be expensive to manage your condition when taking into account the medical bills, but it could make it difficult for you to go back to work. If this is the case, then you may be able to qualify for Social Security Disability Insurance (SSDI). Social Security disability benefits can help to lessen the financial burden of having a debilitating condition, which is why you’ll want to about the process the Social Security Administration uses in order to determine disability eligibility.

How the Social Security Administration Determines Disability Eligibility

When you apply for SSDI, the Social Security Administration will do a thorough evaluation of your case. SSA does this in order to determine if you’re eligible or not. This helps to ensure that those individuals that really need disability benefits get them. While those that are simply trying to take advantage of the system do not.

Keeping that in mind, there are five steps that the Social Administration will take in the course of making their decision. The following are the five steps to determine disability eligibility:

Step 1. Work Activity and Income

To start, the Social Security Administration looks at an individual’s work activity. SSA evaluates income and time at work to see if earnings average more or less than the established Substantial Gainful Activity (SGA) amount. (The amount fluctuates each year.) Based on these findings, an individual may or may not pass the first step of the approval process.

Step 2. Physical And/Or Mental Condition Requirements

To pass the second step of the process, an individual’s physical and/or mental impairment(s) must meet basic duration and severity requirements. Duration requirements are met if impairments will last a minimum of 12 months or will eventually result in death.

Severity requirements are met if an individual’s impairments interfere with their ability to perform basic work-related activities. So if, for example, you suffer from severe anxiety but do not have an official diagnosis from a psychiatrist or medical records that support such a diagnosis, such as that you are on medications for severe anxiety, you’re likely going to be denied.

SSA will move on to the third step of the process if you meet both of these requirements.

3. Evaluate Severity of Medical Condition to Blue Book Listing

Once it’s been confirmed that your condition is serious, your condition will be compared to the medical severity listings in SSA’s Blue Book. The Blue Book contains established medical criteria that are so severe that if a person’s impairment(s) match them, an individual is found to be disabled.

If impairments do not meet or equal one of the listings their application will not move forward to the next step. However, even if an impairment does match a listing it does not guarantee an application will move forward. Individuals must then have their residual functional capacity (RFC) assessed.

An RFC assessment helps establish if an individual has the ability to work full-time. Or, if their mental or physical impairments limit what they can and can not do. Meaning, can they sustain a work schedule that consists of eight hours work days, for five days a week. Pending on the outcome of this assessment, a person may be found to meet step three requirements. As such, they can move forward to step four in the process.

Step 4. Past Relevant Work (PRW)

During step four of the process the SSA takes a look at whether or not an individual could still meet the skill.  They also look at requirements of a past job. If an individual can submit evidence showing they can no longer perform past relevant work due to a physical and/or mental impairment, SSA will go to the final step of the process.

Step 5. Burden of Proof for SSA

For step five of the process, the Social Security Administration evaluates whether or not an individual’s impairments would allow them to perform other work currently available in the national economy. During this final step, SSA does take into account an individual’s RFC, education, work experience and age. If an individual can not adjust to other work, and meets all other rules and requirements of step five, they meet the disability burden of proof.

These five steps that the Social Security Administration takes to determine disability eligibility can confuse disability applicants. If you have any questions about your disability eligibility or would like professional guidance applying for benefits, be sure to schedule a free consultation with us at Social Security Disability Advocates USA. Simply call (602) 952-3200 today, submit an online form, or click to chat with us online. We are available 24 hours a day, seven days a week.

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