5 Things Judges Look for when Deciding a Disability Case

Few people understand that Social Security disability decisions are made by applying a standard legal formula, following five steps in order.  If, at any step in the process, a judge can make decision to completely deny or allow disability, he or she will not continue on to assess the other factors.  This legal process is known as the “sequential evaluation of disability.”

Here are the five steps, in order:

1. Is the person working?
   • Working means engaging in “substantial gainful activity.”  This means that if the person is working and has gross wages above a certain amount, they cannot be found disabled, and will be denied disability without any consideration of medical conditions
2. Does the person have a severe impairment?
   • If a person’s medical condition does not cause at least some work related restrictions, the judge will deny the claim at this step.  However, few people are denied at this level, and the judge moves on to the next step
3. Does the person have a medical condition that meets or equals a listed impairment?
   • The legal regulations for disability contain a large list of diseases and medical conditions that are presumed to be disabling.  If a person has one of those diseases or medical problems described in the listings, the judge will award disability without the need to consider any other factors such as work history or age. If the person cannot be found disabled at this level, the judge will consider the next step in the process.
4. Can the person return to his or her past relevant work?
   • “Past relevant work” is defined in the disability rules.  It means any significant work performed within the past 15 years.  If a person is capable of performing any past relevant work, they will be denied disability at this step.  The judge can deny the case at this level without any consideration of practical “real world” considerations such as whether the past relevant job is available or whether the person would be hired if they applied, or whether the work even exists in the area in which they live. If the person cannot return to any past relevant work, the judge moves on to the last step.
5. Is the person capable of performing any other work?
   • Yes, you guessed it, that term also has a specific legal definition. “Any other work” means jobs that exist in significant numbers in the national economy.  By far, this is the most complicated step in the disability evaluation process. Age, education, work experience, skill level, and transferability of skills are all combined with the classification of the persons physical and mental work restrictions to create a vocational profile.  If that profile matches a job or jobs that exist in the national economy, the person will be found “not disabled”.  If the profile does not match up with any of those jobs, then the person is considered “disabled” under the law.  There are medical- vocational guidelines in the law that help judges make the decision at this final step.  However, most judges also take testimony from a vocational knowledgeable to assist them in reaching a final decision. U.S. labor force statistics are used to identify jobs in the national economy.

At this final step in the disability evaluation process, there are legal presumptions about how a person’s age, education and skill levels affect the ability to perform work they have never performed before. For example, younger workers are presumed to be more adaptable to new and different types of jobs.

This is a general outline of the sequential evaluation of disability.  There are a vast number of rules, regulations and exceptions that further define and clarify factors at each step in the sequential evaluation process.  It can take many years of study and practice to really understand the disability evaluation process, and usually one only learns these regulations and exceptions by dealing with them first-hand.

If you have been denied disability by Social Security, there is something you can do. Stansberry Kinsley handles Social Security disability claims. If we can help you turn your disability denial into an approval, give us a call at 844-327-5529.

Related practice pages: Denied Benefits and Appeals.