How does the Judge decide if you get Social Security Disability Benefits?

ALJs follow a five-step sequential analysis to determine whether you’re disabled. It’s called a sequential analysis because it works like a flow chart or a decision tree. At each step, the ALJ asks a question, and the answer determines what happens next.

First, the ALJ asks whether you are working? This seems like a straightforward question, but it’s not. For the purposes of this post, if you ARE working, the analysis is over. You can’t go on to the second step and you can’t get disability benefits. You may go on to the second step only if you are NOT working.

Next the ALJ asks whether you have a severe medical or mental impairment that affects your ability to work? This is a low hurdle, but if your impairments are not “severe” as defined by the regulations, you are not disabled and you can’t go on to step three. You can go on to the next step only if you have a severe impairment.

Third, are your impairments severe enough to meet a “Listing”? This is the first point where the ALJ can find you disabled. If you meet a listing, the analysis is over. You get your benefits. But the test at the third step is extremely difficult. There are fourteen different categories of impairments, or “Listings.” To meet one you have to present medical evidence proving you have one of the listed conditions, and that you’re as bad off as described in the listings. If you don’t meet a listing, you go on to the fourth step.

Fourth, do you have the Residual Functional Capacity to do any of your past jobs? This step is actually a two-part test. First, the ALJ determines your Residual Functional Capacity (your RFC), and then whether your RFC prevents you from doing work you did in the past. The “RFC” asks, “How bad off are you, really?” You’ve proved you have a severe impairment, but it’s not bad enough to meet a listing. Is it bad enough to keep you from doing any job you did in the past? If not, then you’re not disabled and you can’t go on to the fifth step. If yes, you can go on to the fifth step.

Fifth, and finally, the ALJ asks whether there is there another job in the national economy you could do despite your impairments? Despite the fact that your impairments prevent you from doing work you did in the past, the Commissioner gets to try to prove there is a job you could do despite your impairment. The Commissioner has to actually prove that such a job exists, and the ALJ has to take your RFC, your educational level, your work experience and your age into consideration when evaluating any job the commissioner proposes. If such a job exists, then you’re not disabled, but if the Commissioner can’t prove such a job exists, you get your benefits.