How Social Security Determines Disability

By the Greater Wisconsin Agency on Aging Resources Legal Services Team

Submitted by Stephanie Rasmussen, Disability Benefit Specialist (DBS) 

If you’ve applied or thought about applying for Social Security disability benefits, you may have heard about the five-step process the Social Security Administration (SSA) uses to decide whether someone is disabled. Understanding how SSA makes disability determinations can help you understand why a claim was approved or denied. Read on to learn more about the process.

Step 1: Are you working?

Social Security first looks at whether you are working and earning over a certain monthly amount. If you are earning too much, SSA usually decides that you are not disabled. If you are not working or earn below the limit, SSA will send the application to the Disability Determination Bureau (DDB) for the remaining steps.

Step 2: Is your condition severe?

Next, the DDB looks at your medical conditions. To qualify, your condition must be serious enough to limit your ability to do basic work activities, such as standing, lifting, remembering instructions, or concentrating. If the condition is not considered severe, the claim is denied. If it is severe, the DDB continues to Step 3.

Step 3: Is your condition on SSA’s list?

SSA has a list of medical conditions that are considered automatically disabling. If your condition meets or equals one of these listings, you are determined to be disabled. If it does not, the DDB will move on to the next step. 

Step 4: Can you do your past work?

At this step, the DDB reviews the jobs you have done in the last 15 years. They decide whether you can still do any of that work based on your medical limits. If you can still perform your past work, your claim is denied. If you cannot, the DDB goes to the final step.

Step 5: Can you do any other work? 

Finally, the DDB looks at whether you can do any other type of work that exists in the national economy. They consider your age, education, work experience, and physical or mental limitations. If SSA decides you cannot adjust to other work, you are found disabled. If they decide you can work, the claim is denied.

For more information, please see: https://www.ssa.gov/benefits/disability/qualify.html.