How the Social Security Administration Determines if you are Disabled

The Social Security Administration (SSA) offers 2 disability programs: the Social Security disability program and the Supplemental Security Income (SSI) program. A 5-step evaluation process is applied in each case regardless of what types of benefits you are seeking. Although the SSA’s evaluation process consists of 5 steps, not all the steps are necessarily reached if the SSA determined that you are – or are not – disabled at an earlier stage in the process. The SSA proceeds sequentially and if it determines that you are disabled at Step 3, for example, it will not proceed on to Steps 4 and 5.

The 5-step sequential evaluation consists of the following steps:

  1. Determining that you are not engaged in “substantial gainful activity” (SGA); and
  2. Determining that you have a “severe” impairment; and
  3. Determining that your impairment is listed in the regulations or is equivalent to one of the impairments on the “Listing of Impairments;” or
  4. Determining that you are incapable of performing your “past relevant work” (“PRW) in light of your “residual functioning capacity;” (RFC) and
  5. Determining that in light of your age, education, work history, and RFC, you are unable to perform other jobs that are available in significant numbers.

Note the numerous quotations marks around certain legally significant terms and the liberal use of abbreviations. These terms, commonly referred to as “defined” terms, have a precise meaning within the context of the regulations. An experienced Vancouver disability lawyer will be able to explain what these terms mean, which is important because they often have obscure meanings.

After engaging in the 5-step sequential evaluation, the SSA will decide whether you meet the “duration requirement.” That is, you must be disabled for at least 12 complete months.

In a nutshell, there are 2 routes to a disability determination. Under the first route, the SSA engages in the sequential evaluation process and stops at Step 3, determining that your impairment is a listed impairment or the equivalent of a listed impairment. Under the second route, the SSA engages in the evaluation process, determining at the end of Step 5 that you are impaired within the meaning of the regulations.

On the flip side, there are six routes to a determination that you are not disabled within the meaning of the regulations. From the SSA’s perspective you are not disabled if you:

  • are engaging in SGA
  • do not have a severe medically determinable impairment
  • have a medically determinable impairment, but it is not severe enough to significantly limit your physical or mental ability to perform basic work functions
  • can perform past relevant work
  • are capable of other work
  • fail to satisfy the 12-month duration requirement.

You might want to consult experienced Vancouver disability lawyer Marla Heikkala at Marla Heikkala & Associates. The SSI program has additional requirements as well, relating to both your assets and income.