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Determining Disability through the Five-Step Process

By Edited Jun 25, 2016 0 0

The benefits for the different disability claims under the Social Security Administration can only be awarded to people who have been found disabled by the agency. The disability claim evaluation process is so detailed that any small error done by the claimant may cost his application. In determining claimant's eligibility of the medical condition, the agency uses five steps or questions.

1. Are you engaging in SGA (Substantial Gainful Activity)?

    The basic example of SGA is working. If the claimant is working despite the impairment, he should be earning a limited amount per month, or below the level of SGA. The amount changes every year; but as of the moment, earning over $860 per month may disqualify the claimant from being approved. Special regulations are implemented for self-employed claimants.

    2. Do you have a medical impairment that is more than non severe?

      To be approved of benefits, the condition must be severe. In this question, the SSA wants to know if the claimant's disability is severe enough to limit his ability to perform basic activities like walking, standing, carrying, hearing, speaking, seeing, understanding instructions, etc. The disability must also last or is expected to last for 12 months. Non-severe conditions are denied at this point. Severely disabled people will move on to the next step.

      3. Do you have a condition that meets or equals a "listing?"

        To make things easier, the SSA listed medical conditions that are severe enough to limit a person's performance. If the claimant's disability "meet or equal" the criteria of the listing, they are qualified. The listing is called the Disability Evaluation Under Social Security or "Blue Book." Those who do not meet any disability on the listing may still be qualified if they can get past the remaining questions.

        4. Can you do any work that you have previously done in the last 15 years?

          The SSA will then determine whether the claimant can still perform the type of work he did in the past. Examiners will review the medical records, or may send the claimant to consultative examination. If found that he can still do the past relevant work, the claim is denied. Otherwise, the claim will move on to the final step.

          5. Can you do any other type of work?

            Claimant's age, education, work experience, and physical/ mental condition can determine whether he can still perform other work. Vocational rules and GRID will be used to do this. Individuals over 50 may have the advantage because they are not trainable compared to younger people. Claims are denied if the person can still do other work, while those who cannot will have their claims approved.

            Consult with an expert Social Security Disability Lawyer in Los Angeles to help you file the complaint.

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