The Social Security Administration (SSA) defines disability based on strict criteria, and applicants often run into difficulty meeting these standards. Understanding SSA’s definitions and meeting all application requirements is important to the success of a claim. For help with your SSDI or SSI case, reach out to a dedicated disability attorney.
To make a determination about an individual’s disability, the Administration goes through a sequential process. First, they look at whether the person is engaged in substantial gainful activity. It is like a flowchart. If somebody is engaged in substantial gainful activity, they will not going to qualify for benefits. If they are not engaged in substantial gainful activity, they move to the next step of the process.
The next step is to determine whether the applicant has a severe impairment. A severe impairment is any medically determinable condition, either physical or mental, that has either lasted 12 months, is expected to last 12 months, or result in death. It also has to interfere with basic work-related activities. If the administration does not find that there is a severe impairment, or the impairment is expected to pass, the process ends there and the person’s claim will be denied.
Even if SSA determines the individual has a severe impairment, however, the person does not automatically qualify for benefits. SSA first needs to determine whether an individual’s impairments, either singly or in combination, meet or equal the severity of a listing. Social Security has a number of different listings broken up into broad categories of disability. There are listings for neurological problems, digestive issues, mental disabilities, and other conditions. If the individual meets the criteria of a listing, they would have a finding of disability. If not, SSA considers the person’s residual functional capacity (RFC).
RFC is a function-by-function assessment designed to evaluate the applicant’s maximum sustained work ability and limitations. This includes a number of criteria, such as:
SSA looks at all these different issues to determine an individual’s residual functional capacity and compare it to their work history. Given the claimant’s RFC, if they could still perform their past work, the claim is denied. If the person can no longer perform their previous jobs, SSA looks at other work in the national economy. The Administration also considers factors such as age and education.
If SSA determines the individual could perform work aside from their previous job, they would deny the claim. If they determine that the claimant’s residual functional capacity precludes other work, they would approve the claim. This gets easier with age, especially as the applicant reaches their 50s.
SSA’s findings at each step of the claim evaluation process can make or break a disability application. If a claimant makes a small error or does not provide adequate documentation, SSA may believe they do not meet the definition of disability and issue a denial.
If you are unable to work due to injury or illness, Social Security Disability benefits could make a critical difference in your life. To increase your chance of a successful application, consider contacting a dedicated attorney for help with your case. Call now to set up a consultation.