How Does Social Security Determine Disability?



Social Security definition of disability is the same in SSI cases as it is in SSDI cases. It is the "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months". As you can see, the definition of disability for a Social Security disability or SSI claim is not very helpful in trying to figure out if you are disabled. What is significantly more helpful is knowing the sequential evaluation process which is the five step process Social Security uses to determine if you are disabled.  CFR Section 404.1520 explains the five-step sequential evaluation process SSA uses to decide whether you are disabled. "The five-step sequential evaluation process. The sequential evaluation process is a series of five "steps" that we follow in a set order. If we can find that you are disabled or not disabled at a step, we make our determination or decision and we do not go on to the next step. If we cannot find that you are disabled or not disabled at a step, we go on to the next step. Before we go from step three to step four, we assess your residual functional capacity.  We use this residual functional capacity assessment at both step four and step five when we evaluate your claim at these steps."  405.1520 also states “We will consider all evidence in your case record when we make a determination or decision whether you are disabled.”  Below is the process the Social Security Administration uses to determine if you are disabled.  I have tried below to make each step as understandable as possible and for a more detailed explanation of each step you should read the page on this website that explains the particular step you want more information on.  By understanding these five steps you will be on your way to understanding how Social Security will determine if you are disabled.  In the following pages, I will explain in detail each one of these steps so you can better understand the process.  It will help you most if you read them in order.  I also recommend you read how Social Security determines disability on my other website.

Social Security Disability Five Step Process

1.  Are you working? To be eligible for Social Security Disability or SSI you need to be out of work for a year or more or be expected to be out of work for a year or more.


2.  Is your medical condition(s) "severe" under Social Security RulesAn impairment or combination of impairments is considered severe if it significantly limits ones physical or mental abilities to do basic work activities. For an impairment to be found not severe the condition would have no more than a minimal effect on the ability to do basic work activities.


3.  At the third step, Social Security will determine if your impairment meets or equal a listed impairment. Social Security has what is called the medical listings of impairments. It is important to note that even if your condition is one of the conditions in the listing your medical condition must meet the requirements or be equal in severity to what is outlined in those listings for your condition to be found disabled at step three. If they find your medical condition does not meet or equal a listed impairment you then move to step four of the process.


4.  At step four, Social Security will determine if you can do your past work. If it is determined that you can perform your past work you will be found not disabled at this step. If it is found that you cannot perform any of your past relevant work you then move to step five of the process.


5.  At the last step, Social Security will make a decision as to whether or not there is any other work you can do. This is perhaps the most complicated step in the process. For a full explanation of how Social Security determines if there is other work you can perform, see my page devoted to this step in the process.