Am I “Disabled” Enough to get Social Security Disability Benefits?
The Social Security Administration (“SSA”) uses a Five-Step Sequential Evaluation when considering an adult’s application for disability benefits under any of SSA’s various disability programs (E.g., Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), Disabled Adult Child, or Disabled Widow(er)’s Benefits). SSA is always required to go through this process when deciding whether to award or deny an application for benefits. With this in mind, we at Balin Law want to provide you with a brief overview of each of the steps.
Step 1: Are you engaged in Substantial Gainful Activity?
SSA refers to the person applying for disability as the “claimant”. A claimant is not automatically disqualified from receiving disability benefits just because they are working. However, the claimant’s pre-tax earnings must fall below SSA’s monthly Substantial Gainful Activity (“SGA”) limit to be eligible to receive disability. The amount of monthly earnings considered as SGA depends on the nature of the claimant’s disability. SSA specifies a higher SGA amount for statutorily blind individuals and a lower SGA amount for non-blind individuals.
You can view the current SGA levels here: https://www.ssa.gov/oact/cola/sga.html
There are some exceptions to the SGA limit, such as disability-related expenses. You can learn more about these SGA exceptions here.
Step 2: Are your impairments severe?
At Step 2, SSA determines whether the claimant’s various health problems (aka impairments) are “severe.” An impairment is “severe” when it
- significantly interferes with the claimant’s ability to perform either physical (E.g., walking) or mental (E.g., multitasking) work activities; and
- is expected to last at least 12 consecutive months or result in death.
If the claimant’s impairment, or combination of impairments, are found to be severe, then SSA proceeds to Step 3.
Step 3: Do Your Impairments Meet or Equal a Listing?
At Step 3, SSA determines whether the claimant has an impairment, or combination of impairments, that meets or medically equals one of SSA’s listed impairments. Each listing specifies the objective medical and other findings needed to satisfy the criteria of that listing.
A complete list of SSA’s Listings can be found here: https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm.
If the claimant meets or medically equals a Listing, then SSA will find them to be “disabled” at Step 3. If the claimant does not meet or medically equal a Listing, then SSA proceeds to Step 4.
Step 4: Are you able to return to your Past Relevant Work?
At Step 4, SSA determines whether the claimant is able to perform his or her Past Relevant Work (“PRW”). PRW is work that was:
- performed at SGA levels;
- performed long enough for the claimant to learn how to do all the duties of the job; and
- performed within the last 15 years.
If SSA determines that the claimant can perform any of their PRW despite the limiting effects of their impairments, then the claimant is found to be “not disabled” and the analysis ends. If SSA determines that the claimant cannot perform any of their PRW due to their impairments, they proceed to Step 5.
Step 5: Can you adjust to other work?
At Step 5, SSA determines whether the claimant is capable of performing other work that exists in significant numbers in the national economy on a regular, consistent basis (8 hours per day, 5 days per week). This finding is based on the claimant’s age and educational background in addition to the physical and mental limitations caused by their impairments.
If SSA determines that the claimant can adjust to other work, then the claimant is found to be “not disabled” at the fifth and final step of the Five-Step Sequential Evaluation. If SSA determines that the claimant cannot adjust to other work, then the claimant is found to be “disabled.”
Summary of the Five Step Sequential Evaluation Process
This is only a brief summary of how SSA’s Five-Step Sequential Evaluation works. In practice, the analysis is more complicated than can be described in any single blog or a series of blogs. Claimants are advised to contact an experienced disability attorney to assist them with their disability application.
Balin Law works with clients across the U.S.!