HOW THE SOCIAL SECURITY ADMINISTRATION DETERMINES DISABILITY
Claimants are usually surprised when their initial application for Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) benefits are denied. It is understandable to be upset when one receives such a denial, especially when a their “alleged”disabilities are seemingly ignored and are informed in the denial letter that their disabilities are not severe enough to prevent them from going back to work or from finding similar work. At all levels for a claim of SSDI and/or SSI benefits, the Social Security Administration has a 5 step process for determining if an claimant is disabled pursuant to the SSA Guidelines and therefore eligible benefits. In order to provide a better understanding as to why a claim was an initially denied, we discuss the 5 stages in more detail below.
Step 1: Has the Claimant engaged in Substantial Gainful Activity.
The SSA looks to see if the claimant has engaged in any Substantial Gainful Activity (SGA), since their alleged date of onset or date of application. SGA essentially is work. At this step, the SSA sees if the claimant has engaged in any type of work that brought in income. If the claimant has engaged in work, then the SSA looks to see if said work meets the monthly SGA amount. For the year 2011, the SGA amount is $1,000. Therefore if you have worked and made over $1,000.00, then you would not necessary qualify for SSDI or SSI benefits.
Step 2: Are the Claimant’s disabilities Severe.
This is one of the more difficult steps because often a claimant believes that the SSA did not fully consider the severity of the claimant’s disabilities when the initial application was denied. It becomes an argument as to what the claimant subjectively believes and what the SSA objectively sees based on the medical evidence in the record.
This step implies that claimant’s disabilities must be severe enough to significantly limit there ability to perform basic work. In addition the SSA examines whether the claimant’s disabilities will last or, or be expected to last, for a continuous period of not less than 12 months
Step 3: Do the Claimant’s Disabilities Meet or Medically Equal a Listing
Social Security Administration in Tulsa Oklahoma breaks the body down into 13 major systems or listings. Included in these 13 systems are more than 150 categories of medical conditions that, according to Social Security Administration law, are severe enough to prevent an individual from performing any work.
If an individual meets, these listings, then they should be declared disabled under the SSA Guidelines. Often times, this is where the claim is denied, because there is not enough medical evidence on record to support a claim under on of the listings.
Step 4: Can the Claimant Return to Previous Work
This too is often a point of frustration, especially if an individual was let go or asked to leave from the former jobs, because of their inability to complete there jobs The SSA in Oklahoma makes a determination on whether you can return your previous work based on what current limitations you may have and how they would affect your performance at your previous job or a job with similar demands.
If Social Security Administration lawyers finds that a person can return to past work, benefits are denied. If the person cannot, then the process proceeds to the fifth and final step.
Step 5: Can the Claimant Do Any Other Work
As another point of contention, claimant’s often ask, if the SSA determined that they can do other work, then where are those jobs? Unfortunately, the SSA uses national employment figures and does not directly provide information on job availability.
Step 5 determines what other work, if any, the person can perform. Social Security Administration will look at your age, level of education, any skills that you might have that would be transferable to another field of employment, any physical and mental limitations you might have; and finely any residual functional capacity.
The SSA has a set of vocation guidelines (the Grid Rules) to determined disability at this final step.