The Sequential Evaluation Process
When evaluating a claim for Social Security Disability or Supplemental Security Income, the Social Security Administration (SSA) applies a step-by-step process involving five questions, or steps. (20 CFR §§ 404.1520a; 416.920). This is commonly referred to as the “sequential evaluation process:
At step one of the sequential evaluation process the SSA inquires whether the individual applying for benefits is working. If the individual is currently working the SSA will examine how much the individual is earning per month. Typically if an individual’s monthly gross (prior to taxes being taken out) income in 2012 is greater than $1,010 he or she will not be considered disabled. There are exceptions to this rule, which will be addressed in another blog post, however, this is the general rule. If the person is not working or earnings are below the $1,010 cut-off, the SSA proceeds to step two.
At step two, the SSA will determine if the individual applying for benefits has what is referred to as a “medically determinable impairment” that is severe, or a combination of impairments that are severe. An impairment, either mental or physical, is considered “severe” if it significantly limits an individual’s ability to perform basic work activities. (20 CFR §§ 404.1521; 416.921). Some of the basic work activities considered are physical functions such as walking, standing, sitting, lifting, pushing, pulling, reaching, carrying, or handling. The SSA will also consider mental work activities such as understanding, carrying out, and remembering instructions; the use of judgment; and the ability to respond appropriately to supervision, co-workers and usual work situations. If an impairment, or combination of impairments is “not severe” (i.e. there is no more than a minimal effect on an individual’s ability to work) the SSA will conclude the individual is not disabled. If the individual does have a severe impairment, or combination of impairments which are severe, the SSA proceeds to step three.
At step three, the SSA will determine if the individual’s impairment, or combination of impairments, is found to “meet or equal” specific criteria found in the SSA’s Listing of Impairments. The Listing of Impairments outlines conditions which the SSA considers severe enough that they prevent an individual from engaging in gainful activity. Each impairment contained in the Listing of Impairments consists of specific criteria the SSA considers in determining if the impairments “meet or equal” the definition. In order to “meet” the criteria of a specific listing, an individual must have all of the specific requirements of that particular section. If an individual does not have all of the specific requirements of a particular listing, he or she may still “equal” the listing. An impairment can be found to be medically equivalent to a listed impairment even if it does not meet all of the specific criteria, if it “is at least equal in severity and duration to the criteria of any listed impairment.” (20 CFR § 404.1526). This analysis can be very complex and confusing and will be addressed in greater detail in a future blog post. If it is determined that an individual’s impairment or combination of impairments meets or medically equals the criteria of a listing and the impairment has lasted, or can be expected to last at least 12 months, the individual will be found to be disabled. If not, the SSA proceeds to step four.
At step four the SSA will assess an individual’s residual functional capacity, or RFC. Please see the previous blog post entitled “Step 4: Determination of Residual Functional Capacity” for an in-depth look at what is considered in determining an individual’s RFC. After determining an individual’s RFC the SSA will determine whether the individual has the ability to engage in work he or she performed in the last 15 years. This is referred to as the individual’s “past relevant work,” or PRW. If the individual has the ability to do his or her PRW, the SSA will conclude the individual is not disabled. If the individual lacks the ability to perform any of his or her PRW, the SSA proceeds to the next step.
At the fifth, and final step of the sequential evaluation, the SSA will determine whether an individual has the ability, or RFC, to engage in any work aside from his or her PRW. At this step the SSA will consider factors such as an individual’s RFC, age, education, and work experience. If it is determined an individual has the ability to engage in other work in the national economy, the SSA will generally determine the individual is not disabled. If this determination is made, the SSA must provide evidence that such work exists in significant numbers in the national economy. If it is determined the claimant cannot engage in any other work the SSA will determine he or she is disabled.
