September 29, 2011

Social Security Disability Five Step Decision-making process

by Richard S. Griffin

Life is a constant struggle for individuals who are totally disabled by an injury or medical condition. Often winning Social Security Disability (SSDI) or Supplemental Security Income (SSI) is essential in having the income needed to cover your living expenses when you are disabled from work. Because the stakes are so high, it is highly recommended that you seek the representation of an experienced social security attorney if you have a social security disability claim (SSDI).

What is the 5 step process the Social Security Administration uses in determining eligibility for Social Security Disability Income Benefits (SSDI)?
The Social Security Administration follows the following five step evaluation when determining if you are capable of working or if you are disabled from work:
(1) Is the individual capable of earning "sustainable income" (earnings of at least $1,000 per month)?
(2) Does the individual have a "severe medical impairment" that will last for 12 months or longer or result in death?
(3) Does the individual have a medical condition that meets one of the medical conditions or impairments that is on the Social Security "Listings"?
(4) Does the individual's impairment or residual functioning capacity prevent he or she from being capable of performing his or her past relevant work (work within the last 15 years)?
(5) Does the individual's impairment or residual functioning capacity prevent he or she from performing any work in the national economy?

How can I increase my chances of winning my Social Security Disability Benefits?
Social Security Disability claims are routinely denied at the first review of the application. It is during the appeals process where the disabled individuals who take the initiative to hire an experienced social security lawyer that the denied claim often is reversed and social security disability benefits are granted. Why? The Social Security Judge has a limited time to review your social security file. Even though the Social Security Administration may send you out for medical evaluations, these reviews often are very limited and may not produce the medical evidence you need to establish a compensable Social Security Disability Claim. Good social security attorneys can help you obtain the medical evidence and vocational expert evidence you need to prove the elements needed for a winning social security claim.

How can I get a free consultation regarding my Social Security Disability Claim?
You can call The Griffin Law Firm, P.C. at 866-847-6545 and our social security disability law firm will evaluate your social security, worker's compensation, personal injury, or wrongful death claim for free. You can also submit your legal questions or the facts of your claim to us at the following link: FREE CASE EVALUATION

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Relevant law for the evaluation of disability is provided below:

Evaluation of Disability
§404.1520 Evaluation of disability in general.

(a) General—(1) Purpose of this section. This section explains the five-step sequential evaluation process we use to decide whether you are disabled, as defined in §404.1505.

(2) Applicability of these rules. These rules apply to you if you file an application for a period of disability or disability insurance benefits (or both) or for child's insurance benefits based on disability. They also apply if you file an application for widow's or widower's benefits based on disability for months after December 1990. (See §404.1505(a).)

(3) Evidence considered. We will consider all evidence in your case record when we make a determination or decision whether you are disabled.

(4) 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. (See paragraph (e) of this section.) We use this residual functional capacity assessment at both step four and step five when we evaluate your claim at these steps. These are the five steps we follow:

(i) At the first step, we consider your work activity, if any. If you are doing substantial gainful activity, we will find that you are not disabled. (See paragraph (b) of this section.)

(ii) At the second step, we consider the medical severity of your impairment(s). If you do not have a severe medically determinable physical or mental impairment that meets the duration requirement in §404.1509, or a combination of impairments that is severe and meets the duration requirement, we will find that you are not disabled. (See paragraph (c) of this section.)

(iii) At the third step, we also consider the medical severity of your impairment(s). If you have an impairment(s) that meets or equals one of our listings in appendix 1 of this subpart and meets the duration requirement, we will find that you are disabled. (See paragraph (d) of this section.)

(iv) At the fourth step, we consider our assessment of your residual functional capacity and your past relevant work. If you can still do your past relevant work, we will find that you are not disabled. (See paragraph (f) of this section and §404.1560(b).)

(v) At the fifth and last step, we consider our assessment of your residual functional capacity and your age, education, and work experience to see if you can make an adjustment to other work. If you can make an adjustment to other work, we will find that you are not disabled. If you cannot make an adjustment to other work, we will find that you are disabled. (See paragraph (g) of this section and §404.1560(c).)

(5) When you are already receiving disability benefits. If you are already receiving disability benefits, we will use a different sequential evaluation process to decide whether you continue to be disabled. We explain this process in §404.1594(f).

(b) If you are working. If you are working and the work you are doing is substantial gainful activity, we will find that you are not disabled regardless of your medical condition or your age, education, and work experience.

(c) You must have a severe impairment. If you do not have any impairment or combination of impairments which significantly limits your physical or mental ability to do basic work activities, we will find that you do not have a severe impairment and are, therefore, not disabled. We will not consider your age, education, and work experience. However, it is possible for you to have a period of disability for a time in the past even though you do not now have a severe impairment.

(d) When your impairment(s) meets or equals a listed impairment in appendix 1. If you have an impairment(s) which meets the duration requirement and is listed in appendix 1 or is equal to a listed impairment(s), we will find you disabled without considering your age, education, and work experience.

(e) When your impairment(s) does not meet or equal a listed impairment. If your impairment(s) does not meet or equal a listed impairment, we will assess and make a finding about your residual functional capacity based on all the relevant medical and other evidence in your case record, as explained in §404.1545. (See paragraph (g)(2) of this section and §404.1562 for an exception to this rule.) We use our residual functional capacity assessment at the fourth step of the sequential evaluation process to determine if you can do your past relevant work (paragraph (f) of this section) and at the fifth step of the sequential evaluation process (if the evaluation proceeds to this step) to determine if you can adjust to other work (paragraph (g) of this section).

(f) Your impairment(s) must prevent you from doing your past relevant work. If we cannot make a determination or decision at the first three steps of the sequential evaluation process, we will compare our residual functional capacity assessment, which we made under paragraph (e) of this section, with the physical and mental demands of your past relevant work. (See §404.1560(b).) If you can still do this kind of work, we will find that you are not disabled.

(g) Your impairment(s) must prevent you from making an adjustment to any other work. (1) If we find that you cannot do your past relevant work because you have a severe impairment(s) (or you do not have any past relevant work), we will consider the same residual functional capacity assessment we made under paragraph (e) of this section, together with your vocational factors (your age, education, and work experience) to determine if you can make an adjustment to other work. (See §404.1560(c).) If you can make an adjustment to other work, we will find you not disabled. If you cannot, we will find you disabled.

(2) We use different rules if you meet one of the two special medical-vocational profiles described in §404.1562. If you meet one of those profiles, we will find that you cannot make an adjustment to other work, and that you are disabled.

[50 FR 8727, Mar. 5, 1985; 50 FR 19164, May 7, 1985, as amended at 56 FR 36960, Aug. 1, 1991; 65 FR 80308, Dec. 21, 2000; 68 FR 51161, Aug. 26, 2003]