Social Security definition of disability and the five-step process

An attorney can help to explain the somewhat complex law and procedure that govern your application for SSDI or SSI.

The law and procedures that the Social Security Administration (SSA) follows when it processes an application for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) are complicated and not necessarily intuitive. In this article, we will introduce how disability is defined for these benefit programs as well as how the agency analyzes whether a claimant meets that definition for purposes of eligibility.

What is the SSA’s definition of disability?

SSDI is the public disability insurance program funded through payroll deductions. Eligibility depends on a person meeting the definition of disability and on having met work history requirements. SSI is a program for people that also meet this definition of disability, but who don’t meet the work history requirements and have limited income and assets.

The definition of disability is different for these Social Security programs than it is for workers’ compensation eligibility or for benefits through a private disability policy. There is no concept of temporary, partial or permanent disability.

Instead, the Social Security Act directs that an adult is disabled for SSDI or SSI eligibility if they have a medically determinable, severe physical or mental impairment or combination of impairments expected to last at least one year or result in death that prevents them from working.

What is the five-step process?

Based on this definition, the SSA has developed a sequential evaluation process – often called the five-step process – for analyzing whether an adult claimant meets this definition.

1. Is the claimant performing substantial gainful activity (SGA)? SGA is work at an income level that is too high for benefit eligibility. For a person whose disability is not blindness, SGA will be $1310 per month in 2021. If the person is performing SGA, they are not disabled. If they are not working at that level, go to step 2.
2. Is the claimant’s impairment medically severe? To be severe, it must interfere with basic work activities and meet the duration requirement. If not severe, not disabled. If severe, go to step 3.
3. Does the claimant’s impairment or combination of impairments meet or equal the severity of a listed impairment? SSA has a list of impairments that are so devastating that if a claimant meets a listing or equals it in severity, they are automatically presumed disabled. If the claimant meets a listing, they are found disabled at this step. If they do not, go to step 4.
4. Considering the claimant’s residual functional capacity (RFC), could they return to past relevant work? RFC is a person’s remaining physical and mental capacity to meet the demands of working after considering the limitations and restrictions of their impairment. If they could return to previous work, they are not disabled at this step. If they could not, go to step 5.
5. Considering the claimant’s impairments, age, work experience and education could the claimant adjust to any work that exists in “significant numbers in the national economy”? If yes, then not disabled and not eligible. If no, the claimant meets the disability definition.

This is only an introduction to a multifaceted process and complex concepts. An attorney can provide information, guidance, representation and advocacy at any stage of the application, reconsideration and appeals process.

The Maryland law firm of Cohen, Snyder, Eisenberg & Katzenberg P.A. with offices in Baltimore, Glen Burnie, Frederick, Essex and Towson represent disabled SSDI and SSI claimants across the state in their applications and appeals.