5 STEPS SOCIAL SECURITY USES TO DECIDE IF YOU ARE DISABLED

When you file a new application for disability benefits, Social Security will use a five-step sequential process to decide if you are eligible for payments.

1. Social Security will determine whether you are now working at "Substantial Gainful Activity" (SGA) - which is defined in 2021 as earning wages of at least $1,310 per month, gross. If you are, you are not entitled to a disability benefit.

2. Do you have a severe, medically determinable impairment? This impairment should have lasted for at least 12 continuous months, be expected to last for at least 12 straight months, OR to end in death.

3. Social Security will determine if you meet a listing in their Blue Book. These listings are very difficult to meet, so most claimants will not meet a listing. You may still get benefits, however.

4. In Step 4, they must determine whether you can perform any of your Past Relevant Work (PRW) -- defined as any job you performed in the past 15 years--and performed it long enough to do the job satisfactorily. They also only count jobs where you earned "Substantial Gainful Activity" wages for the years involved.

5. In the final Step, Social Security will decide whether you are able to perform any other work which exists in the US economy. This is the step that disqualifies most claimants. Even if you are not able to perform any past work, they may find that you can perform other "less demanding" jobs. This step works against younger individuals who are under age 50. If you are under age 50, you cannot meet a Medical-Vocational Guideline or " grid rule" which directs a finding of disability based on a combination of your age, education, skills, residual functional capacity and past work experience.

You may gather that Social Security disability is a rather technical, complicated matter that doesn't involve much luck. It uses a strict formula.

In the initial application process, only about 25 percent of claimants are approved. The first stage of appeals is called "Reconsideration," and the approval rate there is even more dismal. Your best chance will be at a Hearing level appeal before an Administrative Law Judge or ALJ. Claimants who are represented by an attorney are 3 times more likely to win at the Hearing level, compared to claimants who are not represented. And most claimants only get ONE HEARING.

Using an attorney or advocate who understands how to use medical evidence, vocational factors, skill levels, grid rules, and listings is crucial to success. There is a good reason why a large legal specialty has grown up around Social Security cases. The reason is: these lawyers get results for their disabled clients.