The Social Security Administration is one of the largest federal government agencies, and understanding how it assesses physical disability can be difficult. All applications for disability insurance claims (SSD claims) are initially reviewed by the Disability Determination Service agencies in each state, and all DDS agencies apply a five-step analysis in reaching a final decision.
The first step is to determine whether the applicant is financially eligible for benefits, that is, unable to engage in gainful employment. Anyone who is engaging in substantially gainful activity is usually denied without further question. The second stage is an inquiry into the nature and degree of the applicant’s medical or physical disability. If the impairment is not permanent and total, or if it is not expected to be fatal, the application is also denied. If an application passes steps one and two, the file is next reviewed to determine whether the mental or physical condition satisfies the agency’s written criteria for disability. If an application is denied at this step, it is reviewed to see if the applicant has capacity for any type of work. An applicant that satisfies the written criteria at step 3 is usually approved for an award of benefits.
Applications that are rejected at step 3 may receive further review to clarify the applicant’s ability to perform the kind of work he or she performed in the past or can perform any work at all. If this review determines that the applicant has no ability to work in any capacity, the application will be approved. If the DDS determines that the applicant has some ability to perform gainful work, the application with be denied. At this point, the applicant can ask for reconsideration by the DDS, take an appeal within the SSA or bring an action in federal court.
This summary cannot begin to explain all of the various factors that govern the determination of disability. Anyone contemplating making an application, or anyone who has had an application denied might well benefit from talking to an attorney who specializes if SSA disability law. A knowledgeable lawyer can provide advice on how to submit the application and an evaluation of the likelihood of the application being granted.
Source: Social Security Administration, “Identifying SSA’s Sequential Disability Determination Steps Using Administrative Data,” accessed on Dec. 28, 2015