What is generally thought of as Social Security is now contained in Title II of the Social Security Act (SSA). SSA was originally adopted in 1935 as part of New Deal legislation, which included old age benefits, unemployment benefits and workers’ compensation benefits. Added immediately after the SSA was passed was survivor’s benefits for wives, widows and children, and reduced old age benefits at age 62. In 1950, benefits for widowers were added to the program. In 1956, provision was first made for the payment of disability insurance benefits. Then, in 1974, a separate program under Title XVI of the Social Security Act, called Supplemental Security Income or SSI, was enacted. SSI uses the same definition of disability as is used under SSA. However, there is no prior work requirement; in fact, SSI applicants need never have worked at all since SSI benefits are paid based upon financial need. As a result, the SSI program has stringent income and resource limitations.

The Sequential Analysis

In 1980, a formal decision-making process known as the “Sequential Evaluation Process” was instituted for applicants for SSA and SSI disability benefits. The analysis breaks down the statutory definition of disability into a series of five broad areas of inquiry. The sequential analysis is preferable to the lack of process prior to its use, and it forms a basis for the logical analysis of any case and a clear structure for the presentation of evidence in a hearing.

Step 1: Asks whether or not the claimant is engaging in substantial gainful activity (SGA). In 2012, SGA means that the applicant is earning wages of at least $1,010 / month for non-blind disabled applicants and $1,690 for blind applicants. If an applicant is engaging in SGA, and there was not a continuous period of at least twelve months when the applicant did not earn wages at the SGA level, then the claimant is not disabled. If the applicant is not earning wages at SGA level, move on to Step 2.

Step 2: Is there evidence of a “severe” impairment? “Severe” is defined as significant in terms of functional capacity for basic work-related Activities, such as standing, walking, lifting, carrying, etc. If yes, go to Step 3.

Step 3: Does the applicant’s disability meet or equal the “Listing of Impairments” set forth in 20 CFR 404,Subpart P, Appendix 1? The “Listing of Impairments” identifies specific medical problems that are considered so debilitating that an individual who meets or equals these listings is presumed incapable of substantial gainful work activity, and is deemed “disabled.” If the applicant’s disability does not meet or equal the “Listing of Impairments,” go to Step 4.

Step 4: Considers an individual’s capacity for past relevant work activity. If the claimant’s residual functional capacity (“RFC”) permits performance of past relevant work activity, then the applicant is not disabled. RFC is an effort to measure an applicant’s ability to perform basic work-related activities with their physical and/or mental limitations.

Step 5: What other types of work activity at the substantial gainful activity level might the claimant might be capable of performing? Step 5 is the most difficult and confusing in the process, where most cases are decided or litigated. At step 5, an applicant must prove that, given the claimant’s impairments, he or she is unable to perform any work in the national economy, considering the applicant’s age, education and work experience.

Step 5 focuses the inquiry on an applicant’s exertional and non-exertional impairments. Exertional impairments are those which limit the ability to lift, stand, walk, etc. Non-exertional impairments are problems with mental, psychological functioning. Most disabled claimants present a combination of exertional and non-exertional impairments.

Outline of testimony of an applicant for disability benefits at a Social Security hearing

  • Background information – education; ability to read and write
  • Describe all work performed during the past 15 years
  • Tell why work discontinued
  • Discuss all impairments; when each began; description of symptoms; medical sources consulted; treatments tried; current status
  • Applicant should explain all problems to the hearing officer as if he/she were the applicant’s new doctor
  • Describe all physical and mental limitations
  • Good days and bad days—describe
  • What helps/exacerbates the condition
  • How life has changed since the applicant became disabled
  • Be prepared to address alcohol/drug use
  • Make applicant into a real person with real problems
  • Identify environmental restrictions
  • Psychiatric limitations: memory; concentration/attention span; ability to understand instructions; ability to interact with supervisors/coworkers/public; ability to tolerate work stress; fatigue
  • Pain: nature; frequency; aggravating factors; duration; medications; affect on claimant’s life
  • Applicant should give his/her best estimate of his/her capacity to perform the following activities on a day-to-day basis, 8 hours per day, 5 days per week, 50 weeks per year: Sitting; Standing; Walking; Lifting/Carrying; Manipulating Hands and Arms; Traveling
  • Applicant should describe his/her activities on a typical day
  • If applicant uses prescribed medications, medical aids or assistive devices, bring  them to the hearing