The 5 Step Process: How Does Social Security Decide Whether I Am Disabled?

Establishing Disability

Applicants must be unable to perform substantial gainful activity, which is currently defined as an inability to earn $1,040 per month ($1740 for the blind). The law specifically requires that the applicants impairment must render him or her not just unable to do past work, but unable, to do any other kind of work that exists in the national economy. This requirement is made regardless of whether that work exists in an applicant’s geographic area or whether an applicant would be hired if they applied for the work. Vocational factors, such as experience and education are considered for older applicants with limited skills and education. Hiring an attorney who is experienced in making vocational arguments is very important in establishing disability and entitlement to benefits.

How does Social Security Decide Whether I’m Disabled?

When making determinations about whether a claimant is disabled, Social Security will go through a 5-Step Process. While this may seem to be a simple statement, making the determination that someone is disabled under Social Security’s rules is anything but.

Step 1: Is the claimant working and, if so, are they earning over substantial gainful activity, or, SGA? This is actually fairly straightforward. If someone who has applied for Disability Benefits is working, Social Security will examine their earnings to see if they are earning over SGA, which is currently $1040 If a claimant is working and earning over that amount, Social Security will automatically deny the application. If not, then they will move on to Step Two.

Step 2: Does the claimant have "severe impairments"? At this step, a claimant must show that their impairment has more than a minimal effect on their ability to perform basic work-related activities. For example, if you have applied for disability because you have a back problem, Social Security will look at how that affects your ability to perform activities such as siting, standing, and walking. If your back problem causes more than minimal interference with your ability to perform these activities, Social Security will find that you have a severe impairment and move to the next step.

Step 3: Does the claimant have an impairment that meets or medically equals a listed impairment? Social Security has created a list of conditions for each major body system (such as, musculoskeletal conditions, mental conditions, cardiovascular conditions, etc.) that are so severe that they are automatically considered disabling. If you have conditions that are not included in the listed impairments, or if you have a number of different conditions that do not reach the severity of a listed impairments, Social Security will look at the combination of your impairments to determine whether they combine to equal the severity of a listed impairment.

For example, you may have a back impairment that does not meet the severity needed for an automatic finding of disability, but you also might have arthritis in your knees or hips. Then Social Security would look at all of your impairments together to determine whether they combine to "equal" the severity needed to automatically find that you are disabled under the listing for spinal impairments.

If Social Security finds at this step that your impairments meet or equal a listed impairment, they will find that you are disabled and will not move to the next step. If not, they will move to Step

Step 4: Is the claimant able to perform his/her previous relevant work (PRW)? At this step, if Social Security determines that a claimant is able to perform their PRW, they will deny the claim. Social Security will look at the previous jobs a claimant has performed for 15 years prior to their alleged onset date (the date the claimant provided as the day they became unable to perform full-time work).

In order to make this determination, the adjudicator will examine the claimant’s limitations and construct the claimant’s Residual Functional Capacity (RFC). Essentially, the RFC is a list of the claimant’s limitations with an analysis of how these limitations will affect their ability to perform the tasks found in any of the claimant’s previous jobs.
The RFC should reflect how much the claimant is able to do physically and mentally on a consistent, day-in, day-out basis.

For example, if a claimant can lift 20 pounds occasionally one day, but finds themselves unable to perform any lifting for the rest of the week, the RFC should reflect that the claimant can rarely lift more than 20 pounds. Thus, if all of the claimant’s work involved lifting more than 20 pounds every day, this limitation would not allow the claimant to perform their previous jobs and Social Security would move on to the last step of the 5-Step process.

Step 5: Can the claimant perform any other jobs in the national economy with their limitations? At this step, Social Security will evaluate whether there are other jobs in the national economy that a claimant could perform with his or her limitations. If there are significant limitations that would not be acceptable to an employer (such as: a claimant needs to lie down for more than 2 hours a day due to pain), then Social Security will find that the claimant is disabled at Step 5.

At this step, Social Security bears the burden to prove that there are jobs available in the national economy that a claimant can perform with their specific limitations. Usually, Social Security will use a vocational expert, a person who has experience in placing people in different jobs, to provide testimony about whether a claimant would be able to perform work with the limitations set forth in the RFC. If there are jobs that can be performed, Social Security will find that the claimant is not disabled at Step 5.
 
 
Additional Resources

What is the time frame for filing for Social Security Disability (SSDI) and Supplemental Security Income (SSI)?
 
 

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