A Glimpse Into the SSD Process
March 21st, 2017 by Attorney John Colvin
When a person applies for Social Security Disability, the Social Security Administration applies a multi-step process to determine whether the applicant is eligible for benefits. Following is a general overview of each step of the process.
Step 1: Establishing Financial (Non-Medical) Eligibility
The SSA’s local field offices, such as the offices in Chattanooga, Tullahoma, or McMinnville are responsible for confirming an SSD applicant’s financial or non-medical eligibility, which is based on a person’s work credits. Work credits are directly tied to one’s employment history, and the number of required credits generally increases with age (a person age 58 would need 36 work credits, whereas a person age 44 would need 22 work credits). An applicant with insufficient work credits may be able to qualify for benefits under their spouse’s employment history.
When the field officer determines that an applicant does not meet non-medical eligibility requirements, the claim is denied and is classified as a technical denial. In 2014, 934,825 claims nationwide were denied for technical reasons.
Step 2: Evaluation of Impairment
If an applicant meets financial (non-medical) eligibility requirements, the next step in the process is determining medical eligibility that involves a review of the severity of the applicant’s impairment. First, the impairment must be severe, which means it is likely to last at least 12 months, has already lasted 12 months, or is expected to result in death. The impairment must also make the applicant unable to engage in “substantial gainful activity.” SGA is a certain amount of employment income, which may change from year to year. In 2017, SGA is defined as earnings of more than $1,170 per month (or more than $1,950 per month, if blind).
Even when the SSA finds an impairment to be severe, that’s not an automatic guarantee of benefits, because the next step in the process applies further tests to determine the extent of disability.
Step 3: Meeting Allowable Condition Criteria
The SSA’s listing of impairments bluebook defines all of the medical conditions that the SSA considers to be a disability. But for each of those conditions, an applicant must meet specific criteria. For example, while amputation is a listed impairment, losing one hand is not in itself considered to be a severe disability. Medical evidence must also show that the applicant is unable to use a prosthetic device.
A person whose condition meets the criteria for a listed impairment may be awarded benefits at this stage of the review process. If the SSA is unsure about the severity of the disability, or if the disability is not listed in its bluebook, the SSA may require additional evidence.
Steps 4 and 5: Determining Capacity for Work
The SSA may apply steps 4 and 5 interchangeably, depending on specifics of each case. Step 4 is determining whether the applicant has any capacity for past work, such as a job worked years ago. Step 5 is determining whether the applicant has the capacity for any work, such as a job unrelated to the applicant’s background or training.
In making these determinations, the SSA may seek testimony from employers, teachers, family members, and other people familiar with the applicant’s background, education, and aptitudes. It may also seek testimony from occupational experts, along with additional medical opinions.
Due to staffing shortages, the SSA has fallen behind on processing SSD claims. Any mistake on an application, or failure to include adequate evidence, may result in further delays for applicants in need of benefits. That’s why the most important step in the SSD application process is consulting an experienced SSD attorney.
John R. Colvin, Attorney at Law, has successfully represented clients throughout Tennessee and Alabama who are in need of disability benefits. For over 20 years, he has been helping the injured and disabled put their lives back on track, and he is ready to help you. For advice on how to proceed next or if you have any questions about this topic, call 1-931-962-1044 or submit this online form. Put his bold approach and client focus to work for you.