When you apply for Social Security disability benefits, the Social Security Administration (SSA) wants to know whether your medical disorder is severe enough for you to qualify for benefits. To determine this, the SSA will send your file to the Disability Determination Service (DDS) agency in your state for a medical review.
A claims examiner at DDS, with the help of a medical consultant (M.D. or D.O.) will determine your medical eligibility. DDS is concerned only with determining your medical eligibility for disability benefits (not your legal or financial eligibility).
Any time your claim for disability is evaluated—whether it's your initial application at DDS or when you appeal a DDS decision—Social Security procedures require the claim examiner to address specific issues, in a specific order. The SSA requires this to make sure that everyone gets the same consideration.
If, at any point in the SSA's five-step analysis, the evaluating agency or court determines that your impairments justify an approval of disability benefits, the evaluation ends and you'll receive an award letter. This article explains what happens at every step in the disability determination process.
First, Social Security checks to see if you're currently working or if you've worked since you applied for benefits. If you're working and making a certain amount of money ($1,550 per month or more in 2024), you're probably doing what's called "substantial gainful activity" (SGA, or work).
If you earn more than the allowed level for SGA, you won't qualify for Social Security disability benefits, even if you have an impairment that meets the requirements for disability. If you have no earnings or your earnings fall under the SGA limit, the analysis proceeds to Step 2.
At the second step, the claims examiner who's assigned to your case will first determine whether you have a medically determinable impairment (one that can be shown by clinical or laboratory tests), and second, how severe your impairments are, with the help of a medical consultant. If the claims examiner or medical consultant finds that your impairments don't (or shouldn't) significantly limit the work you could do, your impairment will be considered "not severe" (or non-severe, mild, or slight).
Your claim will be denied if none of your impairments (individually or combined) are considered severe. Medical conditions cover the range of severity from "not severe" to "incapacitating."
The effect of your impairments on your ability to function mentally or physically is what matters, not just the presence of the impairments. For example, if you have severe hypertension (high blood pressure) that might limit the amount of physical work you can safely do, but is controlled with drugs so that your blood pressure is normal, your impairment would be considered "not severe." Similarly, a seriously nearsighted person whose vision can be made clear with glasses doesn't have a severe impairment.
On the other hand, if you have retinal disease that blurs your vision and your condition can't be corrected with glasses, your impairment would be more than "not severe." This same is true for painful arthritis in your spine that can't be improved surgically.
If your impairments are determined to be significant—that is, they're more than "not severe"—the analysis proceeds to Step 3 for further analysis of how your medical condition affects your ability to work.
At the third step of the review, the DDS medical consultant or claims examiner will compare your disability to an official list—called the Listing of Impairments. The consultant or examiner will see if your impairment is on the list of impairments and if it's severe enough to meet (or "equal") the requirements in the listings. The listings differ for adults and for children.
Each impairment listing specifies the degree of severity that's required for you to be found disabled by listing several criteria that you need to meet. If your condition meets the criteria, the DDS claims examiner will presume that you can't do any type of substantial work and will award you benefits.
If your impairments don't match an impairment listing, the medical consultant must consider whether you have an impairment that's equivalent to a similar impairment, in terms of severity (this is called "equaling a listing"). Allowing benefits based on the equal standard recognizes that it's impossible for the SSA to include every medical condition in the listings.
If the medical consultant says your impairments are equally as severe as those in the listings, you'll be granted disability benefits.
For your impairments to be considered equal to a listing, the medical consultant must find one of the following to be true:
If your impairments or combination of impairments don't meet or equal any listing—or combination of listings—the DDS medical consultant will assess your "residual functional capacity" (RFC)—that is, how much ability you still have despite your medical condition. Then the analysis proceeds to Step 4.
If your impairments don't meet or equal any listing, the DDS medical consultant and claims examiner will consider whether your impairments are severe enough to prevent you from doing the kind of work you've done in the past. For this purpose, Social Security looks only at the jobs you've held (for at least 30 days) over the last five years.
If your RFC says that your impairments aren't severe enough to prevent you from doing work you've done in the past five years, your claim will be denied, with the rationale that you should be able to return to your prior line of work. The DDS medical consultant or claims examiner makes this assessment by comparing the limitations in your RFC to the tasks you had to do at your past jobs.
If DDS finds you can't perform your prior work, the analysis proceeds to Step 5.
After agreeing that your impairments prevent you from doing your prior work, the claims examiner next considers whether there are other jobs in the country that you can do despite your limitations.
If DDS believes there is other less physically or mentally demanding work you can do, your claim will be denied on the basis that there are jobs that you can perform. But be clear about this: Social Security doesn't have to find you a particular job, or a job with pay equal to what you used to make, or a job of equal skill, or a job near where you live, in order to deny your claim. The agency just needs to determine that there is work out there in sufficient numbers that you could be doing.
There's an exception to this rule that applies mainly to applicants over 50 or 55. If you're of a certain age and have an RFC for light or sedentary work, Social Security regulations may not expect you to be able to adapt to other work—that is, learn a new job. These "grid rules" require that you don't have recent job education or training or skills you learned from past work that you could easily put to use at other jobs.
If you fit into one of these grid rules, DDS can't deny you benefits in Step 5.
While you're waiting to get a decision from Social Security, you may want to read Nolo's article that discusses disability approval rates for common medical conditions, to help estimate your chances of getting benefits.
If Social Security denies you benefits, see our articles on reasons you could be denied disability benefits and deciding whether to appeal a denied disability claim.
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