In part 4 of our six-part blog series, we look the categories of conditions can meet or equal the list of impairments, known as the listings. Examining whether a claimant meets or is equivalent to the listings is Step 3 of the Five-Step Sequential Evaluation Process used by the Social Security Administration in determining eligibility for benefits under the Social Security Act. I continued working for many years, even though the disability was severe. If any of your impairments exactly match the criteria of a listing, you will be considered disabled and granted disability benefits regardless of your age, education, or work experience. They determine if the applicant can do other work that exists in the regional or national economy. to adjust to other less strenuous work based on your residual functional Retention Date: 09/27/2023 A. Contacting the 800 number or field office (FO) by telephone to inquire about the process, But all five steps may not be neededin your case. The reconsideration process provides the claimant: An opportunity to present additional evidence; A review of the evidence considered in making the initial determination and any other For additional instructions on who may file a request for reconsideration, see (GN 03102.100C.1. For mental illness and some physical disorders, the persons functional limitations must meet all of the criteria listed or specific set as described for the specific listing subcategory. to us. Your impairment is not listed, but it is of the same medical severity as a listed impairment. Ideally, there is enough information for the DDS adjudicator to make a disability determination at this step. benefits. SSA conducts three steps of the disability determination process for children called the sequential evaluation process. or lower than the last grade you completed. Your use of this website constitutes acceptance of the Terms of Use, Supplemental Terms, Privacy Policy and Cookie Policy. The risk of disability is larger than we think: A 20-year-old worker has a 1-in-4 chance of needing disability benefits before reaching full retirement age! we need about your medical condition (s) and your work history, we may Step 3 - Social Security must determine if an individual's medically determinable mental impairment or physical impairment meets or equals the listing criteria of a Social Security medical impairment listing ( listings are in the blue book, which is often called the Social Security Disability list of impairments). consider strong evidence that your educational achievement is higher We assess these factors with your capacity That Plus, examiners annoyed by applicants asking for updates typically work on their claims faster to avoid additional future phone calls. 6 22 comments Add a Comment Extension_Cause544 1 yr. ago So in reconsideration, this step will be faster than in the initial application. STEP #5: Preparation for Decision: This step typically takes 7-14 days to complete. relevant. below are frequently asked questions about Step past 15 years. In addition to his legal work, Marc is If possible, obtain and submit your own medical records with your application (make a copy for your own records first!). Gainful work activity is work performed for pay or profit, or work intended for profit, even if profit is not realized. The treatment of my condition by a medical specialist had been interrupted, because I didnt have health insurance. for work with: In order to make these comparisons, we need a complete description At Step 2, SSA considers the medical severity of the applicant's medically determinable impairment and its duration. in the national economy. This website is produced and published at U.S. taxpayer expense. If your condition is not on the list, Social Security has to decide if it is of equal severity to an impairment on the list. examiner: Determines whether the folder shows all necessary development, including appropriate Submitting any documentation (e.g., letter, facsimile, or additional evidence) indicating For the Disability Determination Services (DDS) responsibilities in . Exert yourself physically for various work-related activities (such Usually, the DDS tries to obtain evidence from the claimant's own medical sources first. There Steps 4 and 5 are more subjective and more difficult to assess but allow for the possibility of approval even though impairment does not meet the severity criteria of a listing. determine whether you are disabled. some circumstances, we consider that persons aged 45-49 are more limited in their Relatively few children have impairments that qualify as functional equals. is why a job title is not enough to describe your work. The type and amount of supports an individual receives while at work is taken into consideration when determining SGA. before the initial determination (e.g., SSA-3373 Function Report, Medical Evidence I have DDS which is Dissolving Disc Disease in my lower lumbar and I have had spinal surgery for that; Ive had surgery on my leg as well and I had hip surgery. The claimant or his or her representative may file a request for reconsideration. I recommend Attorney Roberts as thorough, and dedicated to helping the disabled workers he represents. disagreement with the initial determination. evidence presented; An opportunity for a disability hearing in cases described in DI 29001.001The Right to a Disability Hearing at the Medical Continuing Disability Review (CDR) authority for the Social Security disability programs. have insufficient evidence to evaluate your claim and have to find you To determine this, the SSA will send your file to the Disability Determination Service (DDS) agency in your state for a medical review. Information about your education and training are also very important Social Security representatives in the field offices usually obtain applications For a free Social Security Disability case evaluation. when you stopped working (if not working). This step is critical as it is the first point at which a person can be found disabled. Longmeadow, Massachusetts 01106 If you dont have enough work credits to qualify for SSDI, you must file a Supplemental Security Income (SSI) claim. WAC 388-449-0070 Sequential Evaluation Process step III How does the department determine if you meet SSA listing of impairments criteria? 2. Tolerate certain environmental conditions (such as temperature extremes, But as long as youre contacting the DDS instead of the SSA, its usually fine to request a status update. We have special rules for persons in this For example, a person with the following vocational profile would be stairs or ladders, kneeling, crouching, crawling). are initially processed through a network of local Social Security Administration engaging in classroom, laboratory and online learning; reading, writing, and communication; housing and dining; using technology; navigating the physical environment). auxiliary Understand, remember and carry out instructions. Call today and find out more about our services and let us help you when applying for . A reconsideration determination is made by: An adjudicative team consisting of a disability examiner and a medical consultant Call us at 401-331-8989 to get your claim started right away. done in the national economy, we go to step 5, the final step of our Your claim will be denied if none of your impairments (individually or combined) are considered severe. Can lift no more than 20 pounds for up to 1/3 of an 8-hour workday, Theres no pre-set timeframe for the DDS to make their decision. Select the body systemfor the most disabling impairment (SSABlue Book): 10.00 Still have questions? You have a combination of impairments where none alone is severe enough to meet a listing, but together they are equal to the severity of a listed impairment. Once a reconsideration case on an initial claim has been received from the FO, the are met: There is no allegation of a worsening of any previously documented impairment(s); There is no allegation of any new impairment(s); There has been no treatment for any impairment(s) since the prior determination; and, The prior determination was substantively and technically correct and the prior decision If we decide you are not physically and mentally able to do any The person who decides your claim must use the logic of a doctor, a lawyer, and a rehabilitation counselor to decide if you are eligible for benefits. with the initial determination on his or her claim, or for individuals (e.g. vibrations). If the persons impairment doesnt meet the functional criteria, the person cannot be approved at this step. your ability to adjust to other work. to make an adjustment to other work. document.getElementById( "ak_js_12" ).setAttribute( "value", ( new Date() ).getTime() ); document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Get Access To The Disabled Dentists Guide. 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. A claims examiner, with the help of a medical consultant (M.D. If your condition meets or exceeds the required severity, DDS will presume that you can't do any type of substantial work. document.getElementById( "ak_js_7" ).setAttribute( "value", ( new Date() ).getTime() ); Get Access To Our Denied Disability by Aetna eBook. Attorney Roberts explained how I could get health insurance coverage, so I could go back Read more , ATTORNEY JOHN L. ROBERTS To "medically equal" a listing, the impairment(s) must be at least equal in severity and duration to the criteria of any listed impairment. HomeIMedical & Disability Law Resources. They also assess the applicants residual functional capacity (RFC) based on their current functional abilities. If you do not provide the information The law requires the people at Social Security to consider all of the evidence, and all of your impairments, when they make a disability decision. your age will seriously affect your ability to adjust to other work. After you have filed a disability claim. Consult with medical specialists employed by DDS who can provide expert insights into your specific disability claim. Time to process the claim is often shorter when a person is found disabled at Step 3. 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