Social Security claims are often a lengthy and difficult process. Many claimants who are denied will ultimately be approved for Social Security Disability, so why are they denied to begin with? Most commonly the denials are based upon a lack of medical information and a lack of understanding as to what the Social Security Administration is looking at to determine eligibility. Below, we will look at the five (5) questions the SSA looks at to determine your disability.
Is the Claimant currently working at or above the Substantial Gainful Activity (SGA) level?
Substantial Gainful Activity or SGA is currently $1,010.00 gross income per month. The SSA has a particular calculation method for determining what an individual makes per month, but it cannot exceed $1,010.00 per month. If so, the person is not considered disabled and does not qualify for disability. If you are unsure about your income or have only small periods of time where your income exceeds SGA, you should contact a Social Security Representative to see if you can be considered for disability anyway.
Is the Claimant severely impaired?
“An impairment can be considered non-severe only if it could constitute a “slight abnormality which has such a minimal effect on the individual that it would not be expected to interfere with an individual’s ability to work, irrespective of age, education and past work experience.” Farris v. Secretary of Health and Human Servs., 773 F.2d 85, 89-90 (6th Cir. 1985). Thus, if you have a condition that has more than a minimal effect and can be expected to interfere with your ability to work, you have a severe impairment.
Does the Claimant meet any of the Listings of Impairments?
The Social Security Administration has a guideline for whether a Claimant qualifies for disability based upon certain medical conditions. These are located in the Listings of Impairments on the SSA website. Typically, few Claimants will qualify for a listing based upon their medical records. However, a treating physician can be asked about their condition and answer simple questions to determine if they meet the listing. If a Claimant meets one of the listings, they will be approved at this step in the evaluation process. If they do not meet any listing, then we move on to Step 4.
Can the Claimant return to any of their previous work activity?
The SSA looks at your past relevant work to determine if you can go back to that type of work. Past relevant work is defined as any work within the last 15 years. Medical statements from your treating physician are crucial for this stage of the process. The SSA looks at the Dictionary of Occupational Titles to find a guideline to what the job would typically involve from the physical exertion standpoint. If your doctor states that you cannot do something typically required of that job, you will satisfy this requirement.
Are there any jobs on the open labor market the Claimant could perform?
Up until this point, the burden of proving the disability has been on the Claimant. At this step, the burden shifts to the SSA to prove that there are jobs existing in the open labor market in sufficient numbers that the Claimant could do. They do not have to show that they are in the geographical region of the Claimant, nor that an employer is likely to hire someone. They only have to show that the Claimant is physically capable of the type of work, and that jobs exist out there in the labor market. If so, then the Claimant is not disabled. At this stage, the SSA utilizes the Grid Rules which are described in more detail in a separate article. This is the hurdle that trips up most Claimants.
There are many exceptions and narrowly defined terms within this process that can present obstacles for Claimants. However, the process is the same for all Claimants. This is the information the SSA will be looking for and what they will consider in processing a claim. If you understand what they need and why they want it, often claims can be successfully presented.