The Social Security Disability process can be difficult to navigate, especially when it comes to understanding how your claim will be evaluated. Social Security uses a structured five-step process to determine whether an applicant qualifies for benefits. Each step helps assess the severity of your condition and its impact on your ability to work. Here’s a clear breakdown of what happens at each stage, along with helpful insights to guide you through the process.
Step 1: Are You Working?
The first question Social Security asks is whether you are currently working and earning substantial income. This is referred to as Substantial Gainful Activity (SGA). If your earnings exceed the SGA threshold, you are generally not eligible for benefits.
It’s important to note that Social Security considers only earned income: wages or self-employment earnings. Other forms of income, such as financial assistance or gifts, do not affect this determination. If your income falls below the SGA threshold, your application moves to the next step. This ensures that only individuals whose conditions significantly limit their ability to earn income are considered.
Step 2: Is Your Condition Severe?
In this step, Social Security evaluates whether your condition significantly limits your ability to perform basic work-related activities. These include, for example:
- Standing or walking for extended periods
- Lifting or carrying objects
- Following instructions or maintaining focus
For your condition to be considered severe, it must substantially interfere with your ability to perform work-related activities. Additionally, the condition must have lasted—or be expected to last—for at least 12 months or result in death.
Even if your condition improves temporarily, ongoing or recurring symptoms may still qualify as severe. It’s crucial to provide thorough medical documentation, such as doctor’s notes, treatment records, and test results, to demonstrate the impact of your condition.
Step 3: Does Your Condition Meet a Listing?
Social Security maintains a document called the Listing of Impairments, which outlines specific medical conditions that automatically qualify for benefits if certain medical criteria are met. These listings cover a wide range of body systems and conditions, including, for example:
- Neurological disorders (e.g., epilepsy, multiple sclerosis)
- Musculoskeletal disorders (e.g., arthritis, spinal injuries)
- Mental health conditions (e.g., depression, anxiety, schizophrenia)
Each listing includes strict criteria, such as test results, symptom severity, or functional limitations. A diagnosis alone is not enough in most cases; Social Security must see evidence that your condition also meets the severity requirements in the listing.
If your condition does not meet or equal a listed impairment, don’t be discouraged. Many claims are approved at later steps, where Social Security evaluates how your specific limitations impact your ability to work.
Step 4: Can You Do Your Previous Work?
This step examines whether the limitations from your condition(s) prevents you from performing work you’ve done in the past 5 years that was SGA and performed long enough to have learned the job. Social Security looks at the physical and mental demands of your previous jobs, and your ability to meet those demands with your current limitations. Social Security quantifies your limitations in a finding called your residual functional capacity (RFC) —a measure of what you can still do despite your limitations.
For example, if you worked in construction but can no longer lift heavy materials due to chronic pain, Social Security may determine that you can’t return to that job. But if your condition doesn’t significantly interfere with your past job requirements, your claim will be denied at this stage.
It’s critical to provide detailed information about your work history, including job titles, responsibilities, and the physical or mental demands of each position. This helps Social Security make a fair determination about your ability to return to previous work.
Step 5: Can You Do Any Other Work?
If Social Security determines that you can’t return to your previous work, they will assess whether you can adjust to any other type of work that exists in the national economy. This evaluation considers:
- Age: Older applicants may find it harder to transition to new types of work, which can weigh in their favor.
- Education: Higher education or specialized training may suggest the ability to take on less physically demanding roles.
- Work experience: Skills from past jobs that may transfer to different jobs within your RFC are considered.
Social Security uses a framework to decide disability call the Medical-Vocational Guidelines that take into account the above factors.
If Social Security concludes that no jobs exist that you can reasonably perform, you are “disabled” and qualify for benefits.
Why Understanding the Process Matters
Each step in this process requires specific evidence, from detailed medical records to a comprehensive work history. Understanding what Social Security is looking for at each stage can help you submit a stronger application and avoid unnecessary delays or denials.
It’s also worth noting that many claims are denied initially and approved upon appeal. Don’t be discouraged if your claim isn’t approved right away—sometimes it takes time to gather all the necessary documentation. If you have questions or need help strengthening your case during the appeals process, seeking professional guidance can be invaluable. At Roose & Ressler, we’re dedicated to helping clients every step of the way, ensuring they have the resources and support they need to move forward.
The Roose & Ressler Team is located in Lorain, Toledo, and Wooster, Ohio. You can count on us as your local disability advocates to analyze your case thoroughly in order to determine what is necessary for you to receive benefits. We assess the best methods to prove the crucial facts of your case and gather the necessary evidence. Having 40+ years of experience serving Northern Ohioans, we know the ins and outs of the local disability process.