Lawmakers designed Social Security Disability Insurance to be a long-term benefit program for people who cannot support themselves because they are disabled. In order to ensure that the program's benefits go only to those for whom lawmakers designed the program to aid, applicants need to meet the Social Security Administration's special definition of disability in order to qualify for benefits.
According to the SSA, disability is defined as "the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months."
The SSA has a five step process for determining whether an applicant meets all of the elements of that definition. Social Security attorneys, including Oregon Social security disability attorneys cannot stress enough the importance of understanding all five steps.
Step One: Substantial Gainful Activity
The SSA first looks at whether an applicant is currently working when making a determination about whether an applicant is disabled. While it is possible for a person to work and receive Social Security benefits, if a person is making more than $980 per month, the SSA considers the applicant able to engage in "substantial gainful activity" and is, therefore, not disabled.
Step Two: Severity of Condition
If an applicant is making less than the SGA amount, the SSA will then look to see how severe the applicant's condition is and whether the condition is the reason that the applicant is not able to engage in SGA. Since Social Security is a long-term benefit program, one of the first criteria that the SSA assesses is whether the condition will last at least 12 months or if the applicant will die from the condition within 12 months.
If the applicant's condition is not severe enough to interfere with working, then the SSA will not consider the applicant disabled.
Step Three: Listed Condition
If the SSA does decide that an applicant's condition is severe enough to prevent him or her from doing employment-related activities, the next thing a screener looks for is whether the condition is on the SSA's list of impairments for which it provides benefits. The SSA's list contains a range of conditions, including both physical and mental impairments. If the condition is on the list and the applicant's symptoms are severe enough to meet the SSA's criteria for when the listed condition prevents someone from working, then the SSA will consider the applicant to have a disabling condition.
It is important to note that just because an applicant has a condition that is on the list of impairments, it does not automatically mean that an applicant is disabled. For example, many people suffer from degenerative disc disease, one of the SSA's listed impairments, but not everyone with the condition suffers so badly that they cannot work.
Step Four: Ability to Perform Previous Work
If the SSA concludes that an applicant has a severe condition but that condition is not on the list of impairments, the next step is for the SSA to examine the applicant's past work to see if the applicant can continue to do that work or if the condition prevents the applicant from returning to that type of employment.
If the SSA decides that the applicant can do the work that he or she has done in the past, then the applicant does not qualify as disabled.
Step Five: Ability to Perform Alternative Work
If the SSA determines that the applicant cannot return to his or her previous type of employment, the SSA will then look to see if the applicant is able to perform an alternative form of work. The SSA looks at an applicant's education, past work history, age and potential for retraining to assess whether the applicant has skills and training that will transfer into other fields of employment that may be less demanding on the applicant. If, based on these factors, the SSA concludes that the applicant is able to do other work and there are a significant number of such jobs available in the national economy, the SSA will not consider the applicant disabled.
The number of steps that the SSA takes in determining whether an applicant meets its definition of disabled reveals how complicated applying for Social Security benefits can be.
There are a number of ways that the SSA can deny an applicant and unless an applicant knows all of the information that goes into a decision about disability, he or she could forget to include some information that would show the SSA that the applicant cannot work. The importance of obtaining legal assistance knowledgeable in this area of law is vital.
