We are often asked how Social Security Judges evaluate Social Security Disability appeals that come before them. The answer to that question is simple. Social Security formalized a five-step sequential evaluation process to determine if a Claimant should be entitled to Social Security Disability benefits (SSDI). In fact, Judges typically write their decisions utilizing the five step process. So what is this five-step evaluation process?
Have you been Unable to Work for 12 Months?
This is always an easy step to make, at least in Claimants that come to me. If the applicant has not been out of work for 12 or more months or is not expected to be out for 12 or more months, my intake with the client ends. If you haven’t been out of work or expect to be out of work for 12 or more months, then you are NOT ELIGIBLE for SSD. It’s that simple.
If you do not meet this step, then no need to go any further. If you have not or do not expect to have substantial gainful employment (8 hours per day, five days per week, 40 hours per week) for 12 or more months, then you move to Step 2.
Do you have a Severe Medical Impairment?
The condition and medical records you provide must find your alleged condition(s) to be a ‘severe medically determinable impairment.’ In my practice, this is not an issue. Social security usually indicates on a denial letter that “although your medical condition is severe . . . ” If your condition was not considered to be severe, I would not consider your appeal.
Medical records, diagnostics reports, and reports for your Doctor would indicate the severity of your condition. In many regards, my clients are told by their doctors to apply for SSD. That’s a pretty good indication that your medical records will reference a severe medical condition. So, if your medical condition is determined to be severe, then move to Step 3.
Does the Severity of the Impairment Meet the Listings?
Federal Regulations contains a list of medical conditions within a description of a certain severity of that impairment. For example, an applicant can be awarded benefits for Diabetes. However, just because you have Diabetes does not mean you meet that listing nor does it mean you are eligible for SSD. To meet the listing, you must meet the specific criteria for that listing.
The criteria are very specific and must be documented throughout the medical records. If your medical records indicate that you meet a listing, then the sequential process ends and benefits can be awarded. I find most clients do not meet a listing, because if they did, they likely would not have been denied at the local office level. In fact, some Judges do not want listing arguments, because they believe if the medical records indicated a listing, then benefits would not have been denied. If you do not meet a listing, we then go to Step 4.
Can you Perform Their Past Relevant Work?
First, what is past relevant work? Past relevant work is work that you have done over the past 15 years. There is also an issue with whether you performed that specific work long enough to be deemed to be past relevant work. If the work is determined to be past relevant work, then it will be classified as one of the following:
- Sedentary work
- Light work
- Medium work
- Heavy work
These determinations are based on exertion levels, both as classified (within the Dictionary of Occupational Titles) and as customarily performed. Legal arguments can be made to dispute whether the appropriate work designation is made. If it is determined that the you can perform your past relevant work then the Judge will deny benefits.
Social Security will determine your residual functional capacity (RFC). This is their determination based on your file review and possibly a consultative examination on what specifically they believe you can still do despite your medical conditions. If the Judge finds you can’t perform any past relevant work, then we move on to the final Step 5.
Can you Perform Other Work?
This is step is where most social security disability cases are argued. If you can’t do any past relevant work, then the Judge must decide if you can do any other types of jobs. The examination under this step considers your RFC, your age, your education, and any relevant skills to determine what other types of jobs you may be able to do.
A vocational expert is present in your social security hearing to possibly identify jobs that you may be able to do, within your RFC and restrictions identified by the Judge. If it is determined that you can’t perform any other work, then your will be granted SSD benefits. It is a complex argument to make, which is why you should have an experience Social Security Disability attorney on your side. You have one hearing. One chance.
Count on Mooney
Mooney & Associates handles social security disability appeals. We are not the type of law firm or agency that will lead you on for months only to drop your case right before your hearing date. We will provide an honest assessment of your case. We fight vigorously for our clients.
Mooney & Associates has 15 offices spread throughout Central Pennsylvania including:
If you have applied for social security disability benefits and have been denied, call us today for a FREE CONSULTATION to discuss your case. Contact us today for a free consultation or call us at 717-632-4656 or toll free at 877-632-4656.