A Successful Disability Claim – More
than Just a Diagnosis
The Social Security Administration’s
Five-Step Sequential Evaluation Process
One of the
things I hear most often from a client whose claim for disability is rejected
is, “I can’t believe Social Security turned me down for benefits, I told them I
have [insert ailment/disease/injury].”
What surprises clients even more is
when I tell them that two people of the exact same age, with the exact same medical
diagnosis, may not both be eligible for Social Security Disability benefits. In other words, a successful disability claim
requires more than just a medical diagnosis.
In the
Social Security Administration's (SSA’s) Five-Step disability analysis,
the diagnosis of a severe, medically determinable impairment is required at Step
Two. But having a severe, medically
determinable impairment, in and of itself, does not prove that an individual
cannot work.
Once a severe, medically
determinable impairment is established at Step Two, SSA is interested in how
this impairment affects an individual’s Residual Functional Capacity
(RFC). RFC is defined by the SSA as
"the most you can still do despite your limitations.” Because the limiting effects of injuries
and/or diseases can be different for different people, individuals with
identical diagnoses may have vastly different RFC’s.
The RFC assessment is most
important at Steps Four and Five of the disability analysis. At Step Four, the SSA asks whether an
individual can do any of his/her past
jobs. If it determines that the answer
to this question is “No”, the SSA moves to Step 5 and asks whether an
individual can do any other work. An RFC assessment can be for a physical
and/or a mental condition.
For severe physical conditions, an
RFC consists of an assessment of the individual’s ability to engage in a
variety of physical activities during an 8-hour workday, including the length
of time you can sit/stand/ and walk, how much weight you can lift and how often
you can lift it, the functionality of your upper and lower extremities, and
several other categories.
For severe psychological and
psychiatric conditions, an RFC will consist of assessing an individual’s
capacities to understand and remember, stay focused on tasks, interact with
other people, and adapt to changes in the workplace.
For an individual to be successful
in his/her claim for disability, that person must generally prove that there is
no full-time employment that he/she can still do[1]
on either a physical or mental basis, or a combination of the two. This is a difficult requirement, which means
that securing experienced, competent legal representation for your claim is
essential.
- Eric J. Patrick, Esq.
- Eric J. Patrick, Esq.
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