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Disability Evaluation for Social Security: The Five-Step Process

By   /  October 24, 2016  /  8 Comments

Learn here about the five-step qualification process the SSA will use for your disability evaluation for Social Security benefits and you’re closer to approval.

5-step-evaluation processThe Social Security Administration uses a basic 5-step process to determine eligibility for disability benefits:

Step 1: Are you working?
If your disability allows you to work, and you’re able to earn more than a certain amount per month then (usually) the SSA does not consider you to be disabled. The earnings limit in 2017 for non-blind persons is $1,170/month; for the blind, $1,950.  This amount is adjusted each year.

Step 2: Is your disability severe?
If your average earned income per month does not exceed the limit, then the SSA passes your application along to the Disability Determination Services (DDS) office in your state. For the DDS medical examiners to determine that, indeed, you are disabled; your medical condition must significantly limit your ability to do basic work activities—such as walking, sitting, and remembering—for at least one year. If your disability is not that severe, they will decide that you are not eligible for SSD benefits. But if it is that severe, the DDS goes on to…

Step 3: Is your medical condition on the List of Impairments (LOI)?
The DDS refers to the LOI to see if your condition is listed. If it is, then it automatically means that you are disabled as defined by law. If it isn’t, then the DDS looks to see if your condition is as severe as a condition that is on the list. If it is, then they will consider you to be disabled. If it isn’t, they go on to…

Step 4: Can you do the work you did before?
The DDS decides if your medical condition prevents you from being able to do the work you did before. (Or something similar.) If you can still do it, they will decide that you are not disabled. But if your disability does prevent you from doing that kind of work, the DDS goes on to…

Step 5: Can you do any other type of work?
The DDS looks to see if you could do some other type of work, despite your disability. It evaluates your age, education, medical condition (physical or mental), work experience, and any skills you may have that could be used to do some other work. If you cannot, they will determine that you are disabled. But if you can do other work (even if you don’t care to), then you are deemed not disabled and, therefore, ineligible for SSD benefits.

 

Disability Evaluation for Social Security: The Five-Step Process
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  • Published: 2 months ago on October 24, 2016
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  • Last Modified: December 5, 2016 @ 8:09 pm
  • Filed Under: Claims Process

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  • LeeArtress

    Hello Kay,
    I have been diagnosed with peripheral artery disease and originally applied for ssdi in June of 2014 after bypass surgery in my right leg and a forefoot amputation on the right foot. I was denied because I didn’t understand the process and did not follow through correctly. I applied again in march of 2016 and had a physical CE on November 22 in which the doctor told me I met a listing(.45 abi). My question is how soon could I see an approval and will I get back pay retroactive to my original application date? Thanks!

    • Kay Derochie

      Dear Lee,

      You could get a decision in a month or it could take much longer; it depends on how busy your area’s Disability Determination Services is. You will be paid based on the current application; maximum retroactivity before month of application is twelve months.

      Sincerely,
      Kay

      • LeeArtress

        Thank you.

        • Kay Derochie

          You are welcome, Lee.

  • I had a question but can’t find the response HELP

    • Kay Derochie

      Dear Treviszia,

      Responses are not generally posted immediately. Your question was answered a few minutes ago, but you posted it under a different Social Security article so you may continue to have trouble finding it. Here’s what I responded:

      The processing time for new claims runs from two to five months. I suggest that you call the DDS and ask the examiner whether they are waiting for anything from your doctors. If so, you can try to follow up on the needed records or statements. If nothing is needed, politely ask for a realistic estimate for completion of the review. Note that the DDS does not get the claim immediately and three months from when they got it would be after November 11 (not October 31) when allowing at least a week for the DDS to receive the claim. So, you might want to wait to follow up until about November 18.

      Sincerely,
      Kay

  • Dimitra

    Hi , I have been found disabled, my husband gets 850.00 monthly from ssd we are raising our 11 year old Granddaughter we both have a car my granddaughter gets 250.00 monthly from public assistance, would I still be eligible for ssi

    • Kay Derochie

      Dear Dimitra,

      If you are approved for Social Security, your benefit will be based on your earnings record, not on your family income and assets.

      If you were medically approved for Supplemental Security Income (SSI), you will be eligible for SSI if your and your husband’s countable resources including the equity value of the vehicle with the lower equity value are $3,000 or less. Equity value is the retail value reduced by the amount you owe on the vehicle. Your granddaughter’s support and income do not affect (SSI) payment.

      If your resources are below the limit, you and your husband will each receive $135 SSI if he also applies for SSI and you and he are treated as an SSI eligible couple. Couple rate $1,100 – $830 (all but $20 of SSD) = $270 / 2 people = $135. If he does not apply for SSI, your SSI benefit would be about $386. The value in his applying for SSI would be that he could get Medicaid, which would likely pay his Medicare Part B premium for him as well as providing prescription coverage.

      Sincerely,
      Kay