THE FIVE STEPS TO GETTING DISABILITY BENEFITS

Prep Before You Step: An Introduction

The disability evaluation process is a structured sequence of five critical steps, where failure at any step—except the third*—leads to a denial of benefits. The process begins with assessing if you can perform Substantial Gainful Activity (SGA), moves through evaluating the severity of your impairment, and requires meeting specific medical criteria outlined in Listings of Impairments. It then considers your Residual Functional Capacity (RFC) and past relevant work to determine if you can still perform prior job functions. Finally, if you cannot return to your past work, the process examines if you can adapt to other available jobs, factoring in age, education, and transferable skills.

Step One: SGA

In this first step, the Social Security Administration (SSA) determines whether you’re engaging in Substantial Gainful Activity by assessing your work earnings and activity level. If your income exceeds a certain threshold, it suggests you’re capable of working and thus not eligible for disability benefits. Only if your work is deemed nonsubstantial will the evaluation proceed to the next step.

Step Two: Severity

In this step, the SSA assesses whether your impairment is severe enough to limit your ability to perform essential work activities. To be successful, your condition must impose significant restrictions on your daily life and work functions. Conversely, if the impairment does not meet this severity threshold, your claim will likely not advance to the next step.

Step Three: The List*

Next, the SSA checks if your impairment matches one of the specific conditions listed in their “Listings of Impairments.” These listings include 14 categories with detailed medical criteria for various impairments. To qualify, your condition must meet the exact requirements outlined for that listing. Otherwise, your claim will proceed to the next evaluation step.

Step Four: Residual Functional Capacity

Here, the SSA evaluates your RFC, which measures what you can physically and mentally do despite your impairments. They then classify your past work—that is, work done in the 15 years before your disability—by its exertion level: sedentary, light, medium, heavy, or very heavy. Significantly, if your RFC shows you cannot reasonably perform any of your previous jobs, your claim will likely advance to the final evaluation step.

Step Five: Stepping Back

Based on your RFC, the SSA determines if you can perform any other type of work besides your past relevant jobs. To do this, the SSA considers your age, education, and transferable skills (that is, any abilities and experiences from your previous work that can be applied to different jobs).

NOTE: If you’re over 55 and restricted to sedentary work, or over 60 and limited to light work, the SSA mandates that vocational adjustments be minimal. In other words, any new job opportunities must involve only minor changes in work settings, tools, and/or processes.