The Sequential Evaluation Process
At each level of the Social Security appeals process, the Administration considers the following steps to determine if a claimant is disabled
(See 20 C.F.R. 404.1520 for Title II cases (i.e. disability insurance benefits) and 20 C.F.R. 416.920 for Title XVI cases (i.e. SSI cases):
404.1505 Basic definition of disability.
(a) The law defines 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.
1. Is the claimant working?
This is technically stated as: “Is the claimant engaged in substantial gainful activity (SGA)?” 404.1520(b) and 416.920(b). SGA is in turn defined as earning more than $700 per month. (This is a recent change; prior to July 1999, SGA was defined as $500 per month. See 64 FR 7559, February 16, 1999.)
2. Does the claimant have a severe impairment?
Basically, a severe impairment is a medical or physical impairment (or combination of impairments) that is supported by objective evidence that would “significantly limit” a persons ability to do basic work activities. The threshold
for this step is relatively low, as long as there is objective evidence of the impairment. (SSA recently issued a ruling addressing Chronic Fatigue Syndrome (CFS) as a severe impairment, although it is difficult to diagnose with testing, See SSR 99-2p (April 30, 1999))
3. Does the claimant meet or equal a listing?
20 C.F.R. Pt. 404, Subpt. P, App. 1 is a part of the Social Security Regulations that contains a list of certain medical conditions that result in an “automatic” finding that a claimant is disabled. These are usually very hard to meet, because even when
a claimant is extremely ill or disabled, often their problems have not been documented to the extent that is required by the listing. (Recently the listing for claimants suffering from Obesity was deleted. See 64 FR 46122, August 24 1999, effective October 25, 1999)
4. Can the claimant perform his or her past work?
A claimant is found to not be disabled in he or she can perform “past relevant work.” This is usually defined as work performed within the last 15 years, and it must have been performed long enough for the claimant to have learned the job. The tricky part of this step is that a person can be found to be able to do the “kind” of past work they have done. 20 C.F.R. 404.1560(b).
The distinction there is that a person’s individual job may have had more demanding requirements than that particular job usually has in the economy, so that a claimant can be found “not disabled” if the claimant can’t do the same job done in the past, but can do the job as it is usually performed.
5. Can the claimant perform other work?
If the claimant can’t do past work and all the other steps above are satisfied, then the burden shifts to the Social Security Administration to show the claimant can perform other work in the economy. The majority of cases are decided at this step. The Commissioner may meet his burden by relying on the testimony of a VE or by relying on the “Grid” regulations. 20 C.F.R. Pt. 404, Subpt. P, App. 2 (the “Grids”) are a set of charts found in the regulations that consider a persons age, education, previous work experience, and previously acquired skills and dictate a finding
of disabled or not. (Recently, SSA has proposed changing part of the grid rules for claimants 55 and older. Currently, claimants 55 and older must currently have “highly marketable” skills before those skills can be determined to be transferable. The proposed regulation would do away with that requirement, making it more difficult for a claimant 55 and over to win under the grids. See Notice of proposed rulemaking 64 FR 42310, August 4, 1999)