How does Social Security decide whether to grant or deny benefits?

In our experience as Roanoke disability lawyers, almost every client has been curious about how the Social Security Administration will make the disability determination in his or her case. Although the facts and circumstances of every case are unique to the individual claimant, every claimant must pass the same test in order to be awarded Social Security disability benefits. Simply put, you must prove that you meet Social Security’s legal definition of “disabled.”

Preliminary requirements

As a threshold matter, you must establish that (a) you not presently working; and (b) you have a severe physical or mental impairment that has lasted for 12 months, or is expected to last long or to result in death. Once you establish that you meet these prerequisites, then you must prove your entitlement to benefits by one of the following routes.

Two routes to an award of benefits

(1) Do you have a Listings impairment?
The Social Security Listing of Impairments (commonly called the “Listings”) is a collection of more than 100 physical and mental conditions that Social Security deems severe enough to prevent a person from working and render him “disabled” as a matter of law. The Listings establish specific criteria for each listed condition; in general, only the most severe manifestations of a particular condition appear in the Listings. If you are able to establish that the medical signs and symptoms of your impairment meet or “medically equal” those of a Listings impairment, then no further proof is required. You are “disabled” and will be awarded Social Security disability benefits.

(2) Does your impairment prevent you from working?
If you do not have a Listings impairment, then Social Security will consider the severity of your impairment as it relates your ability to work. First, the decision-maker will evaluate whether your impairment prevents you from doing the work you have done in the past. In general, if you are able to do the easiest job you have done in the past 5 years, then you are not “disabled” and will not be awarded benefits. If, however, you are not able to do your past work, then the decision-maker will consider whether you would be able to adapt to another type of work. In making this determination, Social Security will consider your age, education, work history, and your current ability to function despite the limitations caused by your impairment. If, taking all these factors into consideration, you are not able to work, then you will be awarded Social Security disability benefits.

Our experienced Roanoke disability lawyers can guide the way

Social Security calls its decision-making process the “5-step sequential evaluation process.” As this flowchart illustrates, a “wrong” answer at any point in the analysis will result in the denial of your claim. Navigating this process to a successful conclusion is easier if you have a knowledgeable and experienced Roanoke disability lawyer guiding the way. If you would like to speak with us about your initial application or appeal, please use the Free Claim Evaluation form on this page to tell us about your case, or call or email us directly.