The Sequential Evaluation: Not As Intimidating As It Sounds!
The Sequential Evaluation. Doesn’t that sound like something out of a science fiction novel? However, the Sequential Evaluation is part of something far more confusing and complex that any sci-fi plot . . . Social Security Disability!
What is the Sequential Evaluation?
From our previous Social Security Disability (SSD) blogs, you know there are two main factors that qualify someone for benefits:
- Their condition has lasted, or is expected to last, at least 12 months, or is expected to result in their death
- The medical condition prevents them from doing any substantial work.
This might seem straightforward, but these two simple questions present many complications. How severe does a condition have to be? What is substantial work? What if an applicant can do some work, but not the work they used to do?
This is where the Sequential Evaluation comes in. It is a five-step process that determines the severity of the disability and the applicant’s potential for gainful employment. If an applicants is “not disabled” at any step, the process ends. As a result, their application gets denied.
Is the individual working above SGA level?
First, the Social Security Administration (SSA) considers income. SGA stands for substantive gainful employment. It refers to the amount of money an applicant is able to earn each month. The amount changes each year, and varies for blind and non-blind applicants. If an applicant is working above SGA level, they are not considered disabled by SSA. This is because benefits are reserved for people who can’t earn substantial income due to their condition.
Is the individual’s physical and/or mental condition severe?
At this step, SSA returns to the basic questions. How long has the impairment lasted? Will it result in the applicant’s death? If a disability is only temporary, the application is likely to be denied at this step.
At this step, physical and/or mental limitation is also considered. The SSA looks at physical activities like sitting or walking, plus mental activities like comprehension and remembering.
Does the individual’s medical condition meet or equal the severity of a Listing?
Due to their severity, some conditions automatically qualify an applicant for SSD. The listing includes serious diseases and conditions like cystic fibrosis, cerebral palsy, and Down syndrome, as well as various forms of cancer. Certain mental disorders are also on the list.
At this step, the applicant’s residual functional capacity (RFC) is also considered. RFC is the individual’s maximum ability to work any sustained work-related mental or physical activities on a regular and continuing basis despite the limitations and restrictions that result from their medically determined impairment. Mental activities also receive evaluation.
Can the individual do any of his/her past relevant work?
Past relevant work (PRW) is any work occurring within the past 15 years. The work must also contribute to substantial gainful activity, and the application should have reached average performance. If an applicant can perform any past work, even if they cannot perform their current work, they will not qualify for disability benefits.
Can the individual make an adjustment to any other work?
Finally, the last step! Similarly to Step 4, Step 5 considers employment circumstances. In some cases, an adjustments allow the applicant to continue work. An adjustment could mean shorter work hours, lighter materials, or anything else that allows the person to continue working and earning wages. If adjustments can be made to current or past relevant work, the applicant can work. Therefore, they do not qualify for SSD.
Overall, the Sequential Evaluation is relatively straightforward. SSD, however, is still complicated. Every scenario is different, and applying for benefits can be a frustrating process. If you are applying for SSD, or if your application was denied, contact a Social Security Disability attorney.
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