THE 5-STAGE EVALUATION PROCESS

All applications for Social Security disabiity (SSDI) must pass through the same five stage evaluation process. This 5 stage process is used at each level: the application level, Reconsideration level, and Hearing level.

The result of this 5-step evaluation process determines whether the claimant meets the rules for disability as set forth by the Social Security Administration and the relevant laws and regulations. Here is that specific evaluation process, which must be done sequentially (starting at Step 1):

Step 1: Is the claimant now working at the level of "Substantial Gainful Activity (SGA)"?That must be answered No before the process can continue. If the claimant is working at SGA level, the case is denied here at Step 1. Note: In 2022, you are working at the SGA level if your gross wages equal at least $1,350 per month.

Step 2: Does the claimant have a severe and medically determinable condition which (a) has already lasted for at least 12 straight months, (b) is expected to last at least 12 straight months, OR (c) will end in death? If the answer is No, the claim is denied at Step 2 without going forward.

Step 3: This step has two parts:

Part A: Does the claimant's severe impairment meet or equal one of the published Listings in 404 Subpart P, Appendix 2? If yes, the claim can be approved here. If not, it goes on to Part B.

Part B: What is the claimant's Residual Functional Capacity ( or RFC? This means, "How much work related activity can the claimant still perform in spite of his or her severe impairment? In other words, can the claimant still work at heavy work? Medium work? Light work? or Sedentary work?

Step 4: Is the claimant still able to perform any of his/her Past Relevant Work (PRW)? This will include any full-time job held within the past 15 year period. If the answer is "Yes," (the claimant could perform at least of his/her past relevant jobs), then the claim is denied here at Step 4.

Step 5: If the claimant has gotten past Step 4, and still has not been denied, the final step considers this question: Is there ANY work in the US economy that this claimant might be able to perform on a full-time basis? If "Yes," there are other jobs the claimant is able to perform, a denial will be issued. If "No," there exists no job in the US economy that the claimant is able to perform, a finding of disability is appropriate.

For most claimants age 55 and over, a decision is made at Step 4. If you are not able to perform any of your past relevant work, you are disabled based on the grid rules or Medical-Vocational Guidelines of §404, Subpart P, Appendix I. An award should be made here.

For most claimants younger than age 50, the case will go to Step 5 where the determining factor will be: "Can you perform any kind of work available in the national economy?"

You can see by this process, that the rules of being found disabled by Social Security are tough. If there is any chance that you are able to continue working (at some job), Social Security will not pay a benefit. The only things considered here are: your age, education, past work experience, and residual functional capacity.

HERE ARE THINGS SOCIAL SECURITY WILL NOT CONSIDER:

• No one will hire me. This is not a disability and it won't be considered.

• I can't live on a minimum wage job. This is not considered by Social Security.

• I don't want an unskilled, minimum wage job. Social Security does not consider the type of work you want.

• I can't drive so don't have transportation to get to work. This is not a disability and does not qualify for an award.

• I don't like to be around people because of my bipolar, schizophrenia, depression ------, etc. Unless Social Security has found that your mental disorder is so severe that you cannot work at any type of job, they will not find this to be a disabling condition.

• Other people get disability benefits who are not as sick as I am. This is the weakest of all arguments and is an absolute waste of time to argue. You cannot bring someone else's condition into your case to help you. It violates all the rules and is, again, a waste of time. Please don't explain this to the judge or ask your attorney to make this argument. It's a "case loser" for sure.

What Can You Do to Get Approved for SSDI?

1. See your doctor and get regular medical treatment, including imaging, X-rays, MRI or other tests to prove your condition(s).

2. Follow your doctor's advice.

3. Be sure Social Security knows about all your medical treatment and gets the records.

4. Fill out a complete, squeaky clean application for benefits. This includes the other forms they will send you: Function Report, Work History Report, questionnaires, etc.

5. Never accept the first decision, likely to be a denial. Appeal each unfavorable decision with the required 60-day window. Don't wait too long to appeal. 60 days!

6. Consider an attorney/advocate who knows Social Security rules and procedures. Without an attorney about 30 percent of claimants win their benefits. With an attorney about 60 percent win their benefits. You are twice as likely to get approved by using a qualified attorney or advocate.

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Posted by: The Forsythe Firm, 7027 Old Madison Pike NW, Huntsville, AL: 35806 (Across from Bridge Street). Our job is to help you get disability benefits.

Free consultations at: (256 799-0297 or (256) 503-8151.