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Applying for Social Security Disability benefits can feel overwhelming. The process is complicated, and many people are unsure why their claim was denied or delayed. To make decisions, the Social Security Administration (SSA) uses a five-step evaluation process. This process is outlined in the federal regulations at 20 C.F.R. § 404.1520. Understanding these steps can help you know what to expect and how to strengthen your claim.
Step 1: Are You Working Right Now?
The SSA first looks at whether you are working. If you are earning more than a certain amount (called substantial gainful activity, or SGA), you will be found not disabled — no matter your medical condition.
If you are not working or earning less than the SGA limit, the SSA moves on to Step 2.
Step 2: Is Your Condition Severe?
At this stage, the SSA decides if your medical condition is severe enough to interfere with basic work activities, such as standing, lifting, concentrating, or remembering instructions.
- If your condition does not limit your ability to perform basic work tasks, your claim will be denied.
- If your condition does cause significant limitations, the SSA continues to Step 3.
RELATED POST: What Happens When DDS Starts a Medical Review of Your SSDI Claim
Step 3: Does Your Condition Match a Listed Impairment?
The SSA maintains a Listing of Impairments — medical conditions considered so serious that they automatically qualify as disabilities. Examples include certain cancers, severe neurological disorders, and advanced heart conditions.
- If your condition meets the requirements of a listed impairment, and it has lasted (or is expected to last) at least 12 months, you will be approved.
- If your condition does not meet or equal a listing, the SSA goes to Step 4.
Fast-Track Programs
Some claims are expedited:
- Compassionate Allowances: Certain diagnoses, like ALS or pancreatic cancer, are almost always approved quickly once confirmed.
- Quick Disability Determinations: SSA uses computer screening to flag cases with a high likelihood of approval for faster review.
Step 4: Can You Still Do Your Past Work?
If your condition is severe but not on the Listings, the SSA looks at whether you can still perform your past relevant work. To do this, they assess your Residual Functional Capacity (RFC).
What is RFC?
RFC is an evaluation of what you can still do despite your medical limitations. It looks at things like how long you can sit, stand, or walk, how much weight you can lift, and how well you can concentrate or interact with others. You can ask your doctor to complete an RFC form in support of your claim.
If your RFC shows that you can still do your past work, your claim will be denied. If not, the SSA continues to Step 5.
Step 5: Can You Do Any Other Type of Work?
Finally, the SSA decides if you could adjust to other work. They consider:
- Your medical conditions
- Your age
- Your education
- Your past work experience
- Any skills that might transfer to a new type of work
If the SSA finds that you cannot reasonably adjust to another job, your claim will be approved. If they believe you can do other work, your claim will be denied.
Continuing Disability Reviews (CDRs)
If you are already receiving disability benefits, the SSA may periodically review your case to see if you are still disabled. This process, called a Continuing Disability Review (CDR), uses a slightly different evaluation method:
- Are you working? If you are earning above SGA, SSA will find you no longer disabled.
- Do you still have a severe impairment? If not, your benefits may stop.
- Does your condition still meet or equal a listed impairment? If yes, you remain approved.
- If not, what is your RFC now? SSA looks at your current abilities.
- Can you still do your past work? If yes, benefits may end.
- Can you adjust to other work? If SSA finds you can, your benefits may stop.
These reviews are intended to make sure benefits continue only for those who remain unable to work.
Why This Process Matters
Many claims are denied at the early steps, often because the claimant does not fully explain their limitations or provide enough medical evidence. Knowing how the SSA evaluates claims helps you (and your doctors) submit stronger evidence from the start.
Get Help With Your Disability Claim
The five-step process may seem straightforward on paper, but in practice it is complex and filled with pitfalls. Most claimants are denied at least once before being approved. Having an experienced disability attorney can make a huge difference in presenting the strongest case possible.
At the Ortiz Law Firm, we guide clients through the disability process, from the initial application and appeals to hearings before an administrative law judge. Call us today at (888) 321-8131 for a free case evaluation.
