How Social Security Decides Whether You Are Disabled
Social Security uses a 5-step evaluation process to decide whether an adult meets its definition of disability. A diagnosis alone isn’t enough, and a condition doesn’t have to appear in the Blue Book to qualify. Instead, Social Security considers how your medical condition affects your ability to work, along with factors such as your work history, age, education, and skills.
Step 1: Are You Working Above SSA’s Applicable Limit?
Social Security first considers whether you’re working and earning above its applicable substantial gainful activity limit. Work activity and earnings can affect whether an adult disability claim moves forward.
Still, working doesn’t automatically mean you can’t qualify. The type of work, amount earned, work accommodations, and whether you can sustain the work may all matter. Because Social Security updates its earnings guidelines, review its current work and earnings guidance or speak with a Boston Social Security disability lawyer about your situation.
Step 2: Is Your Medical Condition Severe?
At this step, Social Security considers whether your physical or mental condition significantly limits your ability to perform basic work activities. These can include standing, walking, lifting, sitting, using your hands, concentrating, remembering instructions, communicating, or handling routine workplace demands.
The condition must be expected to cause these limitations for at least 12 consecutive months or be expected to result in death. A condition can be serious and still require stronger medical evidence explaining how it limits your ability to work.
Step 3: Does Your Condition Meet or Equal a Blue Book Listing?
Social Security’s Listings of Impairments, often called the Blue Book, describe medical conditions and findings that may qualify as disabling at this step. If your condition meets the specific requirements of a listing, or is medically equal in severity to one, Social Security may find that you’re disabled without continuing to the remaining work-related steps.
But not meeting or equaling a Blue Book listing doesn’t end your claim. Many people are found disabled at later steps because the combined effects of their symptoms and limitations prevent them from returning to past work or adjusting to other work.
Step 4: Can You Perform Your Past Relevant Work?
Social Security next compares your remaining abilities with the physical and mental demands of your past relevant work. This generally focuses on work you performed during the 5 years before Social Security makes its decision, provided the work was substantial enough and recent enough to be considered relevant.
The question isn’t simply whether you can return to the exact job you held before. Social Security considers whether you can perform that job as you actually did it or as it is generally performed in the national economy. Medical records, job descriptions, and accurate work-history information can be especially important at this stage.
Step 5: Can You Adjust to Other Work?
If Social Security finds that you can’t perform your past relevant work, it considers whether there is other work you could reasonably adjust to. The agency reviews your age, education, work experience, transferable skills, and residual functional capacity, or RFC.
Your RFC is a practical assessment of what you can still do despite your physical or mental limitations. For example, it may address how long you can sit or stand, how much you can lift, whether you need extra breaks, or how symptoms affect concentration and pace.
A person can qualify for benefits even without meeting a Blue Book listing when the evidence shows they can’t perform past relevant work or adjust to other work. For more detail, see Social Security’s disability evaluation process.
