What are the steps in the SSA's disability determination process?

Five Step Process BlocksIf you have a disabling medical condition that interferes with your ability to work or engage in substantial gainful activity, you may qualify for Social Security Disability Insurance (SSDI). Unfortunately, getting approved for the benefits you need can be challenging. The five-step disability determination process can be lengthy and complicated, and the Social Security Administration (SSA) denies nearly 70 percent of people who apply.

Familiarizing yourself with the process and what happens at each stage may improve your chances for approval, as can working with a knowledgeable and experienced SSDI lawyer when preparing and submitting your application. Here’s what you should know about applying for SSDI, the disability determination process, and how Keefe Disability Law’s exceptional Boston attorneys can assist you.

About the SSDI Evaluation Process

The SSA’s Evaluation Process for Assessing Disability consists of five steps, which are used to determine whether:

  • You’re working or earning enough to be considered engaged in substantial gainful activity
  • Your condition is sufficiently severe and long-lasting
  • You meet or equal a listing for a qualifying disability
  • You’re capable of performing any past relevant work
  • You can adjust to doing other types of work

The process is sequential, meaning that the five steps are always performed in the same order. Additionally, the SSA can determine that you’re disabled and award you benefits—or decide you don’t qualify and deny your claim—at any stage. Working with a skilled disability attorney and including robust evidence is essential.

SSA Disability Assessments

Here’s a more in-depth look at SSDI application evaluations and vital information you should know at various stages of the process.

Step One: Employment and Substantial Gainful Activity

People often incorrectly think that if they’re employed, they can’t collect SSDI. However, that isn’t always the case. When reviewing your application, the SSA will see whether you’re working and, if so, if your earnings indicate substantial gainful activity.

Substantial gainful activity, or SGA, limits are subject to periodic increases related to changes in the national average wage index. In 2022, most SSDI applicants could earn up to $1,350 per month and still maintain eligibility. For statutorily blind applicants, the monthly SGA cap is $2,260 monthly.

Step Two: Severity and Duration of Condition

Next, the disability determination examiner handling your claim will review it to determine whether you meet the severity and duration requirements for SSDI. To qualify, your condition (or a combination of ailments) must be severe enough to interfere with basic work activities and be expected to persist for at least 12 months or result in death.

Step Three: Meeting or Equaling a Listing

The SSA Blue Book Listing of Impairments lists conditions considered sufficiently disabling as well as the medical criteria for approval. If you have a listed health condition and can meet the requirements, you may qualify for SSDI. This path to approval is called “meeting a listing.” However, if you don’t meet the criteria for a listed condition, your medical problem isn’t included in the Blue Book, or you’re disabled due to multiple disorders, completing a residual functional capacity (RFC) assessment can help show the SSA that your impairments are as disabling as qualifying disabilities. Regardless of whether you’re trying to meet or equal a listing, providing evidence from acceptable medical sources (AMS) is crucial to the outcome of your claim.

Step Four: Past Relevant Work Comparison

The disability examiner will then complete a function-by-function comparison of your RFC to your employment history (also known as past relevant work experience or PRW). This helps the SSA determine whether you have the physical or mental capacity to perform any work you’ve done previously.

Step Five: Adjusting to Other Work

When you can’t return to a previous occupation, the disability case examiner will decide whether you’re able to make necessary adjustments to perform any other type of work. If you can’t adjust, the SSA will agree that you’re disabled and award SSDI benefits.

How Our Boston Disability Lawyers Can Help

At Keefe Disability Law, our attorneys are adept at helping clients navigate the SSDI application process to secure the benefits they deserve. Don’t risk a denial. Find out how we can assist you.

Schedule a Consultation

Complete our online contact form or call us at 508-283-5500 to schedule an appointment for a free initial consultation.

 

John L. Keefe
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Founding Attorney, Massachusetts Social Security Disability Lawyer