How Does the SSA Determine Disability?

Social Security Disability Insurance

Social Security Disability Insurance (SSDI or SSD) is intended to compensate individuals with a work history who are too disabled to perform the demands of a full time or near full time job. Supplemental Security Income (SSI) is intended to provide indigent, disabled individuals without a work history with some income. The disability determination process for both programs is the same. That process is completely dependent upon your medical records. The more medical treatment, either for a mental or physical health condition, a claimant receives, the stronger the claim.

Individuals will not receive SSD/SSI based merely on a diagnosis. Instead, the SSA will examine medical records to determine whether the mental and/or physical health conditions are severe enough to cause functional limitations that keep the individual from working. This involves a five step process.

At Step 1, the SSA will consider whether the individual is working. If a claimant is working, is that work below a certain threshold level? If a claimant is earning enough income that they are above the SSA’s threshold, the claimant will not be considered disabled regardless of how much difficulty the claimant is experiencing to stay in the workforce.

At Step 2, the SSA will determine whether the claimant has a medical condition, either physical or mental or a combination of both, that is severe. If the medical condition(s) cause only a minimal impact on the claimant’s ability to work, the claimant will not be considered disabled.

At Step 3, the SSA will evaluate whether, based on the medical records, a “Listing” has been met. The Listings are a highly technical set of rules detailing various medical conditions.

If a Listing has not been met, the SSA moves to Step 4. Prior to Step 4, the SSA determines the claimant’s residual functional capacity to perform work. Then, at Step 4, the SSA evaluates an individual’s past work, and whether that past work can still be performed despite the severe medical condition(s). This is particularly important with individuals over the age of 50.

Finally, at Step 5, the SSA determines whether the claimant is able to perform any other work available in the national economy considering. In doing so, the SSA considers the claimant’s residual functional capacity, age, education, and work experience.

The disability determination process is lengthy and complex. The experienced Social Security Disability attorneys at Tanis Schultz can guide you through the process and maximize your odds of receiving benefits.

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