The disability evaluation under Social Security has five steps. This article discusses each of the five steps and is meant to help applicants, health care providers, and other attorneys understand how the Social Security Administration (SSA) decides claim for different types of disability benefits.

Whether your claim is at the Disability Determination Services (DDS), on appeal before an administrative law judge (ALJ), or in federal court, the Social Security disability evaluation is the same.

If you have a question about how to apply for disability benefits in Virginia, or if you want us to help you win your case, call or e-mail Richmond Social Security disability attorney Corey Pollard today.

Find Out if You Qualify for Social Security Disability in Virginia Under the 5 Step Disability Evaluation

Often we are asked, “Do I qualify for Social Security Disability?” Whether you qualify depends on the answers to the five questions below.

Step 1: Are You Engaged in Substantial Gainful Activity (SGA)?

If you are working and making more than $1,170.00 per month, you may be engaged in substantial gainful activity (SGA).

No matter how disabled you are, the SSA will deny your claim for Social Security Disability Insurance (SSDI) benefits of Supplemental Security Income (SSI) if you are engaged in work at or above the SGA level.

For more information read our article entitled, “What is Substantial Gainful Activity under Social Security Disability?

Step 2: Do You Have One more More Severe Medical Impairments?

The SSA considers a health condition to be a severe medical impairment if it significantly limits the work you can do. It will deny your application for Social Security Disability benefits if it finds that you do not have at least one severe medical impairment.

When determining whether your medical condition is severe, the SSA looks to the functional limitations placed on the you by the impairment. When assessing the extent of functional limitation, the SSA considers several factors.

These factors include: the level of overall functional performance; episodic limitations; the amount of assistance or supervision required; and, the settings where the claimant is able to function. Id. citing, 20 C.F.R. § 404.1520(a)(c)(2).

An impairment is considered severe if the claimant’s ability to perform basic work activities is significantly limited by it.

As stated by the federal court:

Step two does not present a high threshold to meet. An impairment only need be so severe that it could possibly be the basis of a finding of inability to engage in any SGA. SSR 85-28, 1985 WL 56856 (1985) … Due to this minimal threshold, the finding that an impairment is not severe enough to proceed to step three requires a careful analysis of the medical findings and an informed judgment about the impairment’s limiting effect on an individual’s physical and mental abilities to perform basic work activities. SSR 85-28, 1985 WL 56856 (1985). ‘Great care should be exercised in applying the not severe impairment concept.’

As you can see, the SSA should err on the side of caution and find that a condition is severe medical impairment if it has had a continuous impact on your life.

Step 3: Do One or More of Your Severe Medical Impairments Meet the Listing of Impairments?

At step three of the disability evaluation under Social Security the SSA must consider whether you have a severe medical impairment that meets or equals an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. This is the official citation for what is known as Social Security’s Listing of Impairments.

The impairments found in the Listing represent a severity that, if met by the disability claimant, presumes that he or she is unable to perform any type of substantial gainful activity. There are different listings for adults and children.

What impairments are found in the Listing? Many of the mental and physical conditions that you have heard of, but not all If you meet the objective and subjective criteria found in the Listing for your specific medical impairments, the SSA will find you disabled and grant you benefits – regardless of your age, education, and transferable work skills. The disability analysis ends there.

If you do not meet a listing then the SSA must determine if your impairments are equal to the severity required for your impairment or a similar condition. The SSA adds this step to the disability evaluation because it is impossible to put every medical condition in the Listing of Impairments.

Your impairment equals a listing if:

  • Your physical or mental condition is not found in the Listing of Impairments.
  • You do not meet the criteria for a medical listing, but your objective medical evidence has the same meaning as the criteria
  • You suffer from multiple health impairments, none of which is severe enough on its own to meet a listing, but when combined are.

Meeting or equaling a listing is difficult. Many claimants who are ultimately approved for SSDI and SSI do not. Do not give up if you fail to meet a listing.

For more information read our articles on Physical Disabilities and Mental Disorders.

Step 4: Can You Do Any of the Jobs You've Had in the Past 15 Years?

If your severe medical impairments do not meet or equal a listing, the SSA will determine your residual functional capacity (RFC). Your RFC is what you are capable of doing.

Using this RFC, the SSA will decide whether you are capable of doing any of your past relevant work.

Past work includes all the jobs you have performed in the past fifteen years. This fifteen year period is called the “relevant period.” Jobs performed in this period are considered relevant in determining what job skills you have acquired and whether you are disabled. Jobs performed more than fifteen years ago are not considered relevant, or past work.

Some other jobs may be excluded from this “past work” assessment. If you worked a job during the relevant period but did not stay in it long enough to learn all its requirements, then that job is not past work. Further, a job may not be considered past work if you earned below the substantial gainful activity (SGA) level for that given year.

At step four, the SSA is required to determine whether you can return to your past relevant work based on an assessment of the claimant’s Residual Functional Capacity (RFC) and the “physical and mental demands of work [the claimant] has done in the past.” 20 C.F.R. §§ 416.920(e), 404.1520(e).

If the answer is no, we go to step five.

Step 5: Can You Do Any Other Job in the National Economy Given Your Age, Education, and Acquired Job Skills?

At step five of the disability evaluation, the burden shifts to the SSA to show that, considering age, education, work experience, and RFC, you are capable of performing other work that is available in significant numbers in the national economy. If there are other jobs you can do, either because of your RFC or because of skills that are transferable from past work, the SSA will deny your claim.

This step can lead to confusion. Unlike Virginia workers’ compensation claims, the question isn’t whether you can perform your past work. The SSA does not have to find you a job that you like, a job that is hiring now, a job that pays close to what you earned in the past, or even a job near your home. All it has to do is show that there is some work out in the national economy, at any pay rate, that you are capable of doing.

Usually an administrative law judge (ALJ) will obtain the testimony of a Vocational Expert (VE) to support a decision at step five. It is the VE’s response to a properly formulated hypothetical question that guides the ALJ decision as to whether you are entitled to benefits under the Act. This is why it is important to have a disability attorney who can cross-examine the VE and build affective hypotheticals.

Contact Us For Help Qualifying for Social Security Disability Benefits in Virginia

We’ve navigated the disability evaluation process for thousands of clients in Richmond, Newport News, and across Virginia. Call or e-mail us now for help.