By: Disability Group
The Social Security Administration follows a five step process to decide if an applicant is disabled or not at all levels of the process (Initial, reconsideration, hearing). This means that, to decide the claim, SSA will ask five questions, in order. If at any time during the process it is determined that a claimant is or is not disabled, the evaluation stops and they do not advance to the next question. Only at questions 3 and 5 can you win your claim. The five questions are as follows;
1. Are you working?
- If you are not working, SSA moves onto question 2.
- If the answer to this question is yes, than you will lose your claim at this stage and Social Security Administration will not go on to question 2.
- If the answer to this question is yes, but only part-time work you may advance to the next question of SSA determine your part-time work does not meet industry standards.
2. Do you have a severe impairment, expected to last at least 12 months or result in death?
- If the answer to this question is no the process stops and the claim is denied at this stage.
- If your impairment is considered severe then SSA moves onto question 3.
- A severe impairment is one that significantly affects capacity to do work-related activities.
3. Does your impairment or combination of impairments meet or equal the listings that SSA maintains?
- If the answer to this question is yes and your conditions meets a listing set forth in “The Blue Book” than you will win your case at this stage. They will not go onto question four. It is extremely difficult to win your case at this stage.
- If your condition does not meet a listing SSA will move onto question 4.
- SSA defines some conditions as severe and has listed these conditions in what they call “The Blue Book”.
4. Are you able to return to your past relevant work?
- At this stage, if SSA determines you are able to return to a previous job then you lose at this point.
- If at this stage SSA determines you are not able to return to any past work, they will move onto question 5.
- Past relevant work is work that was performed in the previous 15 years.
- At this stage SSA will have the claimant fill out questionnaires to determine if the activities performed on a regular basis can be applied to a job.
5. Considering your age, education, and work experience, is there any other jobs that exist in significant numbers in the national economy that you are able to do?
- If SSA succeeds in finding a job in the national economy that the claimant could perform your claim is denied at this stage.
- If no such job exists then you are found disabled and you win your case.
- At this stage it is the Social Security Administration’s responsibility to prove that a job exists in significant numbers that the claimant can perform effectively.
This five question structure is the basic structure used at every stage of the claims and appeals process in a disability benefits case. It is extremely important to file an appeal within 60 days of receiving a denial letter. If the claimant fails to file within the time frame given (60 days) the applicant must start over from the beginning (initial level). For this reason some claimants choose to hire representation At Disability Group, Inc. our trained legal staff will guide your through the stages and take care of your claim from start to finish including filing any necessary appeals and representing you at the hearing level if necessary. Call us today for a free legal consultation.