Social Security Claims Analysis:

Disability for the purposes of Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) is the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment or combination of impairments that can be expected to result in death or that has lasted or can be expected to last for at least 12 consecutive months.  This social security analysis standard can be broken down as follows:

Step 1 – Substantial Gainful Activity:

Generally, the Social Security Administration (SSA) wants to know if a person is still working.  SSA determines whether a person is doing something that involves significant physical or mental activities and whether it is the type of activity normally done for pay or profit.  If someone is working and earning a certain amount each month (SGA level), SSA will consider them to not be disabled, regardless of any actual disability.  A person who might otherwise be disabled will not be able to receive benefits while they are currently engaging in substantial work.  20 C.F.R. 404.1520 (b).

Step 2 – “Severe” Medically Determinable Impairment:

SSA determines whether a person has a “severe” impairment or combination of impairments.  Impairments are “severe” if they significantly limit a person’s ability to perform basic work activities. Generally, an impairment is “severe” if it imposes more than a minor limitation in someone’s ability to do work or life functions.  SSA considers all impairments, including symptoms like pain or fatigue, in determining whether a condition is “severe.”  20 C.F.R. 404.1520 (c).

SSA also figures out whether an impairment meets the durational requirements at step 2.  The impairment must have lasted or is expected to last for more than 12 months or is expected to result in death.  20 C.F.R. 404.1521.

Step 3 – Listings:

SSA determines whether a claimant meets any of the “Listings.”  The Listings are descriptions of certain conditions and the impairments they cause.  Generally, a condition that meets a Listing is considered so severe that the claimant is automatically considered disabled.  If the condition does not rise to “Listing level” SSA then goes on to Step 4.  The Listings are codified at 20 C.F.R. Part 404, Subpart P, Appendix 1. 

Step 4 – Past Relevant Work:

Most social security cases, at whatever level, are won or lost at steps four and five of the process.  Step four is where SSA first determines a claimant’s “residual functional capacity” which is their ability to do work.  SSA then determines whether someone can do their “past relevant work.”  If a person is no longer able to do the work they used to do, the process proceeds to step five. However, if SSA finds that the claimant is still able to do their old work, they will find that the person is not disabled. 20 C.F.R. 404.1520 (f).

Step 5 – Any Other Work:

Finally, SSA must determine whether the claimant can do any other work in the national economy, considering that person’s age, educational background, work experience, and residual functional capacity.  To make this determination, SSA uses a set of “Grid Rules” and ALJ’s often consult with vocational experts.  If it is found that that they are not able to engage in other work as a result of their impairments, that person is entitled to benefits, possibly including back benefits depending on the onset date of the disability.  20 C.F.R. 404.1520 (g).

It also possible for a judge to find a claimant is not capable of any other work outside of the Grid Rules if there are additional limitations that erode the claimant’s residual functional capacity to the point that no work would be available or able to be maintained long term.

The social security analysis process is complex.  You need a qualified attorney to help guide you through the process.