MANDATORY 5-STEP PROCESS FOR SSDI DECISION MAKERS

By law, Social Security must use a mandatory five-step process when deciding if a person is entitled to disability benefits. The five-step process is sequential. The claimant must pass Step 1 before going on to Step 2, etc. Here are the 5 steps, and I have simplified them as much as possible.

STEP 1: Is the claimant now working at substantial gainful activity? (Is he/she working and earning at least $1,170 per month)? This number changes year-to-year. If Yes, a denial is issued. If No, go on to Step 2.

STEP 2: Does the claimant have at least one severe medical impairment that is expected to last for at least 12 consecutive months OR to end in death? If Yes, go on to Step 3. If No, a denial of benefits is issued here.

STEP 3: Does the claimant have a medical impairment that meets one of the listed impairments in Social Security's Blue Book? If Yes, a favorable decision or award is issued here. If No, the hearing will continue to Step 4 after the decision maker determines the claimant's Residual Functional Capacity (RFC)*

STEP 4: Is the claimant able to return to any one of his/her past relevant jobs? Past relevant work includes any job performed at substantial gainful activity level within the past 15 year period. If Yes, a denial is issued. If No, the case moves on to Step 5. Note: In cases of claimants who are age 50 or over, it is possible that a finding of "No" may result in an award at Step 4.

STEP 5: Is the claimant able to perform ANY other work which is available in significant numbers in the national economy? If Yes, a denial will be issued. If No, a favorable award is made to the claimant.

SUMMARY: Claimants under age 50 must generally prove that they cannot perform (a) any past relevant work AND (b) cannot perform any other type of work available in the US economy, even if it is work that have no interest in doing, cannot find or could not live on. Claimants age 50 or more may only have to prove that they cannot perform any past relevant work (and may not have to worry about other jobs in the economy). At age 55, it is even more likely that a claimant can win disability at Step 4.

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*Residual Functional Capacity (RFC) is the maximum that an individual is able to do in spite of his/her impairments. Obviously, a person whose RFC limits them to performing sedentary work is more likely to be found disabled than a person who can perform medium or heavy work.