disability determination process

The 5-Step Disability Determination Process

For someone filing a disability claim, it can be a long and tedious process. But did you know that the process doesn’t stop when you hit “submit” on your application? Once all of your information and documentation has been sent off, you might be done, but the process is really only just beginning. When your claim hits the SSA, it then goes through another process that is used to ultimately determine whether your claim will be accepted or rejected.

 

This disability determination process consists of five crucial steps — and while a claim can actually be rejected or accepted at any step along the way, a large number of claims actually go all the way through before a final determination is made. So, what are these steps?

 

Step 1: Assessing Your Income:

The first step is to determine whether or not you are currently working. If not, your claim moves to step 2. If you are, the SSA needs to see if your income exceeds the SGA (Substantial Gainful Activity) limit. Currently, that limit is set at $1,170 per month. If you make more than that, you can pretty much assume your claim will be denied.

 

Step 2: Assessing the Severity of Your Impairment:

At this stage, your condition is assessed in terms of severity. The SSA is not really interested yet in the type of impairment — just that it exists, and is enough to be labeled “severe.” If it isn’t considered severe, the claim is denied. If it is, it moves on to step 3.

 

Step 3: Assessing Your Impairment’s Blue Book Listing

The SSA has a document called the Blue Book which lists many different types of impairments, and what criteria need to be met. If your condition meets the criteria for one of these, your claim is automatically approved then and there. If not, the SSA then decides whether or not your specific condition is equal in severity to those in the Blue Book listings. If not, your claim is typically denied. If so, it moves to step 4.

 

Step 4: Assessing Your Past Work

If you have been determined to have a non-listed, yet severe impairment, the SSA will then try and determine if you are able to do any work from your work history. So, at this point the SSA will look at all of the jobs you have had to see if you are able to still perform any of them. If so, you will be denied since you can still work. If not, your claim will move to step 5.

 

Step 5: Assessing Your Ability to Do Any Work

The final step in the disability determination process relates to your overall ability. If your impairment is severe enough that you can’t work at any of your previous jobs, the SSA will make one final sweep to determine if you are able to do any meaningful work at all. If so, your claim will be denied. If not, congratulations! Your claim has been approved!