The Rules of Social Security Administration Disability Determinations

Social Security Administration is a bureaucracy. And like all bureaucracies, the decision makers at SSA must follow their internal rules. When deciding whether a person is disabled, the Agency follows a five-step analysis: 1. Is the individual working? If working in 2021 and earning more than $1310 per month (gross) Social Security will say you are not disabled. At Step 2, SSA will look at medical records to see if you have a “severe” “medically determinable impairment” that has lasted or is expected to last 12 months. “Medically determinable” means that you have had treatment and testing expected to diagnose that impairment. “Severe” means that the impairment impacts your ability to work (standing, sitting, lifting, getting along with others, etc.). “Severe” does not mean “disabling”. If you are not working and you have a medically determinable severe impairment, you move to Step Three of the analysis. Step Three asks whether your impairment (or combination of impairments) meets or equals a “Listing.” Social Security has identified multiple physical and mental impairments which they concede would automatically qualify an individual to receive disability benefits if the individual’s condition is as severe as is required by that Listing. In other words, it is not enough that you have been diagnosed with a particular impairment. Your medical records must show that impairment causes limitations specified in the corresponding Listing.

Meeting or equaling a Listing is a very high hurdle. Most people who succeed in getting SSA disability benefits do not have a condition that meets or equals a Listing. Instead, their claim progresses to Step 4 and 5 of the analysis. At Step 4, the decision maker must decide whether, despite your impairments, you can perform any job you did in the past 15 years. If you can’t do your past work, then you move on to Step Five, where Social Security has to decide if there is other work you can perform given your age, education, work experience and your residual functional capacity (what you can still do despite your impairments).

Don’t Wait to Ask For Help. Reach Out Today!

Often, people wait until after they are denied benefits to contact us. Their claims might be legitimate, but are denied due to incomplete medical and vocational information, inexpertly completed applications, or wrongheaded conclusions by their medical consultants. You can avoid these problems by reaching out to us before you file a claim.

We have over 40 years of experience with Social Security claims and private disability appeals. Let our expert team of LTD lawyers represent you, whether it’s preparing all the paperwork necessary to file your application or starting an appeal. We know what documentation is required and have experience dealing with physicians to ensure that medical records submitted to SSA or private insurers are complete. We will handle your claim personally and with compassion.