If your condition does not meet one of the Medical Listings that we discussed last time, SSA moves to step 4 of the sequential evaluation process.  Here, SSA must determine whether you are capable of performing your past work.  In considering past work, SSA only looks at the work that you performed in the past 15 years.  In essence, SSA is concerned with the easiest job that you performed in the past 15 years.  If, despite your impairments, you are capable of performing that job, then SSA will determine that you are not disabled.

In order to determine whether you are capable of performing any of your past work, SSA must make an assessment of what is known as your Residual Functional Capacity.  Your RFC is what you can still do despite your impairments.

How is my RFC determined?  Only the SSA decision maker can assess your RFC, but in doing so he must consider your medical evidence, your statements about your limitations, and any opinions provided by your doctors about your limitations.

How is my RFC used to determine whether I can perform my past work?  Well, SSA categorizes jobs as sedentary, light, heavy, and very heavy.  Each category has an exertional functional capacity requirement.  To perform a particular job, you must be able to perform the exertional requirements for that job.  For example, if your easiest job in the past 15 years is categorized as light, you must have the ability to lift 20lbs occasionally, 10lbs frequently, and to stand or walk most of an 8 hour work day to perform that job.

What if my easiest job required me to do more than the way SSA categorizes it?  It doesn’t matter.  SSA is only concerned with whether you have the RFC to perform the job as it is ordinarily done.  But, if your past work was actually easier than the SSA categories, then SSA will look at how you actually performed the job to see if your RFC will allow you to perform it again.  Doesn’t seem fair, does it?

If I can’t perform my past work, will I be found disabled?  Not necessarily.  If you can perform your past work, you won’t be found disabled.  If you can’t, the evaluation moves to the final step of disability determination, which is a determination of whether you can perform any other work that exists in significant numbers in the national economy.

Continuing with my discussion of the SSA disability evaluation process, today I am going to talk about Step 3, the Listing of Impairments.

Social Security’s Listings of Impairments is exactly what the name implies.  It is a list of severe conditions that contains criteria for medical signs, findings and symptoms.  If your medical condition meets these criteria then you are found disabled at this step and the analysis stops.  However, proof that your condition satisfies the criteria can be difficult to establish.  Objective medical records from your treating doctors are critical to be successful at this step.  The Listing criteria are very specific and require a relatively high level of severity.  Your medical records must contain the exact information required by the Listing, or demonstrate an equivalency to the required information.  Because of the specificity requirements of the medical evidence and because of the severity level that must be established by the evidence, many claimants who have been diagnosed with a condition named in the Listings will not be found disabled at this step.  This is often because of poor records keeping by your medical providers or because your condition has not yet advanced to the level required by the Listings for presumptive disability.

Don’t be discouraged, though.  The Listing step is unique.  If you can’t prove that your condition meets the requirements of the Listings, the evaluation does not stop at this step and it does not mean that Social Security will not find you disabled.  You still get to move on to step 4 of the evaluation.  We’ll talk about that in SSA Disability Basics Part 5.

If you want to see what conditions are covered in the Listings and how complicated the criteria are, you can take a look at them here.

Thanks for reading.

Mike Hartup

I’m going to take a break today from my discussion of SSA basics due to time constraints with my hearing schedule, but here is a good article on the current SSA case backlog.

Clients are often frustrated by the time it takes for their case to reach a conclusion.  In West Tennessee, claims generally take 483 days to process in Memphis and 568 days in Nashville once they reach the hearing stage due to the government’s case backlog.  As you can see from the article, the waiting time is much longer in other parts of the country.  While an attorney can certainly increase the odds of a favorable decision, there is very little that he or she can do to speed up the process.  Unfortunately, it appears that the backlog will only get worse with the “Baby Boomer” generation getting older.

It truly saddens me to see disabled people lose everything they have worked for while waiting to receive benefits that they are entitled to.  Though it is probably little comfort to you if you are one of the millions waiting, you are not alone.

Once it is determined that a social security disability claimant is not engaged in substantial gainful activity, the next step in the claims analysis is to determine whether the individual suffers from a “severe impairment.”

SSA defines a “severe impairment” as any impairment or combination of impairments which significantly limits your physical or mental ability to do basic work activities.  An impairment significantly limits an individual’s ability to do basic work activities when it has more than a minimal impact on the individual’s ability to perform these basic work activities.  The impairment must be medically determinable, meaning you must provide evidence in the form of medical records or tests to prove the existence of the impairment.

Generally speaking, this is not a difficult test for SSA claimant’s to pass, but you’ve got to have that medical evidence to establish the existence of the impairment.

Tomorrow, we will talk about which severe impairments SSA considers to be disabling at step three of the process without considering whether you are capable of performing your past work.

Yesterday, I talked about the sequential evaluation process that SSA uses to determine whether an individual is disabled.  Today, I am going to begin a discussion to explain each step in greater detail.

As you will recall, the first step of evaluation is to determine whether the individual who his claiming disability is currently engaged in “substantial gainful activity” (SGA).  If an individual is participating in SGA, he can not be found disabled.  In short, the question is whether the individual is currently working.  However, not all work will preclude a finding of disabled.

SSA classifies work as SGA only when it is, as the name implies, “substantial” and “gainful.”  To be substantial the work must involve doing significant physical or mental activities.  To be gainful the work must be done for pay or profit.  (Beware that self employed work done at a realized loss can still be found gainful.)  SSA has currently set threshold amounts of monthly income that it considers gainful activity.  You can find those amounts at SSA’s website here.  Not that this would apply to any of my readers, but career criminals should know that illegal activity can and will also be found to be substantial activity.  You probably have bigger problems than disability if this applies to you.

Bottom-line, if you are working and making more than the SGA threshold ($940 in 2008) you can’t be found disabled.  If you’re not, your case gets to move to the next step, which I will discuss on Monday.

Thanks for reading,

Mike Hartup

Today, I thought I would start a short series of posts that explain the basics of filing for disability and the rules that the Social Security Administration (SSA) uses to determine your eligibility for benefits.

Before we get into the application and appeals process, it is important to understand what “disability” means to Social Security.

SSA regulations define “disability” as the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment 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.

In evaluating whether an individual meets this definition of disability, SSA uses a process that it calls the “sequential evaluation.”  This process consists of the following 5 steps of analysis.

The decision maker must:

1.  Determine whether the claimant is currently engaged in “substantial gainful activity” (working). (If yes, the analysis stops with a finding of not disabled.  If no, it continues.)

2.  Determine whether the claimant has a “severe impairment.”  (The answer must be yes to continue.)

3.  Determine whether the “severe impairment” meets or equals one of the listed conditions that SSA has determined to be presumptively disabling. (If yes, the analysis stops here and the claimant is found disabled. If no, the analysis continues to the next step)

4.  Determine whether the “severe impairment” prevents the claimant from performing his past work. (If no, stop.  If yes, continue).

5.  Determine whether the “severe impairment” prevents the claimant from making an adjustment to other work wich exists in significant numbers in the economy. (If yes, he is disabled. If no, he is not disabled).

In my next posts, I will discuss each of these steps in further detail.  I will also discuss the procedures you need to follow in filing your claim for benefits.  In the meantime you can read more details about SSA’s rules in the Social Security Handbook.

Thanks for reading,

Mike Hartup

Often, holders of private long-term disability insurance will find that their policies require them to file for Social Security disability benefits when they make a claim on the private policy.  Many of my clients are surprised to learn that such policies also contain an offset provision, meaning that the private insurance company can reduce the amount of benefits that it has to pay out on a claim when the insured also receives Social Security benefits.  If you are thinking of filing a claim with your private long-term disability insurer, it is important to check your policy to see if you will also have to file for Social Security benefits.  You should also contact a disability attorney for an explanation of the impact that filing both claims will have on your benefits.

Today, the New York times published an interesting article about a lawsuit that accuses some insurance companies of contributing to the current Social Security backlog by forcing their insureds to file for federal benefits.  You can read the article here.

Thanks for reading,

Mike Hartup

Hello, my name is Michael Hartup and I am the attorney that represents our Social Security Disability clients here at Hill Boren.  I’ve created this blog to provide education, news, and comment on Social Security Disability laws and issues.  I hope you will find the content here informative and useful.  Please feel free to contact me any time.

Thanks for reading,

Mike Hartup