How does Social Security evaluate my disability claim?
Social Security uses the same five step process to evaluate both Social Security Disability (SSDI) and Supplemental Security Income (SSI) claims. The five steps used are:
Step 1 – Are you working and earning wages from work at a level deemed to be substantial gainful activity (SGA)? In 2017, the Social Security Administration determined SGA to be earned wages of $1,172.00. This means if you earn wages from working of at least $1,172 per month, you are not eligible for Social Security Disability, regardless of how disabling your condition is.
Step 2 – Do you have a medically determinable physical or mental impairment that is severe or a combination of impairments that are severe? When medical evidence establishes only a slight abnormality or a combination of slight abnormalities which would have no more than a minimum effect on an individual’s ability to work, such impairment(s) will be found “not severe,” and a determination of not disabled will be made. You must also prove that your impairment has either lasted 12 months or is expected to last for a continuous period of at least 12 months.
Step 3 – Do you suffer from a physical or mental condition that meets or medically equals the criteria for a “listing” impairment as defined by Social Security? Social Security has created diagnostic criteria for certain physical and mental conditions called a listing. If an individual does meet the diagnostic criteria of an impairment listing, the disability claim will be approved at this level. If not, their claim will have to be reviewed at steps four and five.
Step 4– Can you perform any of your past relevant work (PRW)? If Social Security determines that even with your disabilities that you could perform any of the jobs that you had in the past fifteen years, your claim will be denied at this level. If you cannot perform your past relevant work, your claim will be reviewed at the fifth and final step.
Step 5– Considering your residual functional capacity (work restrictions), age, education, and work experience, can you perform any substantial gainful activity? If your residual functional capacity is restrictive and your job skills do not transfer to any other kind of work, you may qualify for an approval for disability benefits through a medical-vocational analysis. This analysis involves the use of a set of tables referred to as the medical-vocational guidelines. These guidelines make it easier for older individuals to be found disabled. At this step, the determination will be made as to whether or not you are allowed to receive benefits.
What is the Social Security Disability claim process?
The process for receiving Social Security Disability (SSDI) or Supplemental Security Income (SSI) may involve the following steps:
Initial Application: This is the stage where we provide the Social Security Administration with the relevant information documenting the nature and extent of your disability. The Social Security Administration will send your claim to the Wisconsin Disability Determination Bureau to gather medical information and assess how disabling your physical or mental condition is. Your claim is then returned to the Social Security Administration for a determination as to whether you qualify for benefits.
If you are denied at the Initial Application Stage, you have 60 days from the date you receive the notice from the Social Security Administration to file an appeal which is called a Request for Reconsideration.
Request for Reconsideration: At this stage, we provide updated information to the Social Security Administration about the severity of your condition and about any new problems that you may have developed. Your file is then re-reviewed by different representatives of the Wisconsin Disability Determination Bureau and the Social Security Administration. In this situation, we are hopeful that a fresh set of eyes and a re-examination of the evidence will overturn your denial.
If you are denied at the Reconsideration Stage, you have 60 days from the date you receive the notice from the Social Security Administration to file Request for Hearing.
Request for Hearing: An administrative law judge will review your case and listen to your testimony. Witnesses, such as vocational or medical experts, may testify to help the administrative judge understand important aspects of your case before the judge issues a ruling. We will be there every step of the way to ensure that the judge receives all of the relevant evidence and that you are prepared to respond to the judge’s questions in a manner that increases your chances for a favorable decision.