The Five Steps to Qualify For SSDI or SSI Benefits

INTRODUCTION TO SSA’S SEQUENTIAL EVALUATION PROCESS

The Social Security Administration (SSA) has a five step process to determine if you qualify for SSDI benefits assuming you have enough work credits to be insured for SSDI benefits. There is a sixth step in the SSI benefit evaluation if you are not insured. The answers to these question determine whether the SSA will deny or grant your claim. Every case must go through this process. 

FIRST STEP: ARE YOU WORKING?

The first step of the Social Security review process is really very simple. Are you working? While you are allowed to work a little bit and still claim to be disabled, the limits are fairly low. For 2024 the absolute most you can make per month before taxes is $1550. Above that and you are engaged in Substantial Gainful Activity (SGA) and they will not even look at your medical conditions.

Each year the SGA level goes up according to the cost of living. The SGA amount is higher for those who are blind. For example, SGA for statutorily blind people in 2024 is $2590.

Some people think that they can work and earn just under SGA and still be paid benefits. While technically, this is accurate, it doesn’t play out in reality. The judge thinks that if you can earn some money then you can earn just a little more money. 

STEP TWO: DO YOU HAVE A “SEVERE” MEDICAL CONDITION?

If you have only a slight medical issue which has only a minimal effect on your ability to work, then your medical condition is “not severe.” If the SSA finds your condition is not severe, then they will find you are not disabled.

Therefore, to proceed through the SSA review process, you must show the SSA that you have a severe physical or mental condition or multiple minor conditions that, when combined, limit the work you could do. The SSA’s decision is based on medical opinions and exams from your doctor and the SSA’s doctors. 

Some people have severe medical conditions but are still able to perform activities of daily living and work, because their condition is controlled by treatment. For example, if you have seizures but they are controlled by medications then your illness would not be severe. It is when symptoms do not respond to treatment that it becomes severe. And it is the symptoms which are disabling rather than the diagnosis itself.

There is also a durational requirement for SSDI / SSI. Your severe impairments have to prevent you from working (over SGA) for at least 12 full months although that does not mean you should wait 12 months to apply. Like many things in the law there are exceptions but they can be complicated which is one more reason to hire a good social security lawyer.

STEP THREE: DO YOU MEET OR EQUAL AN SSA LISTING?

At step three, the SSA will look to see if your medical condition meets or equals an SSA listing. The SSA has a list of medical conditions that qualify you for benefits. There are over a hundred specific physical and mental health conditions that qualify for SSDI and SSI benefits.



To be awarded benefits by the SSA, you must meet every element of the listing. This is hard to do so you must have very strong medical evidence. If you do not meet a listing, then a lawyer can argue that you equal a listing. 

STEP FOUR: CAN YOU PERFORM YOUR PAST WORK?

Step four has two parts. The first thing the SSA asks is what is your residual functional capacity (RFC). Social Security will look at the jobs you’ve done over the last 5 years and make a determination, based on your RFC, as to whether or not you can do your past work.

• If the SSA decides you can still do your past work as you actually did it, then they will find that you are not disabled, or
• If the SSA decides you can do your past work as it is generally performed in the national economy, then they will find you are not disabled, or
• If the SSA decides you are not physically and mentally able to do any of your past relevant work, either as you did it or as it is generally done in the national economy, then the SSA will move to step 5. Step five is the final step of the review process.
  

STEP FIVE: CAN YOU DO OTHER WORK?

At step 5, the burden of proof shifts to the SSA to prove that there are “other” jobs (besides your past jobs) that you can do. The SSA important factors include your age, education, work experience, and your RFC. The SSA does not consider whether you will be hired or can find a job. They are only interested in whether you are able to work.



The SSA uses of a set of tables known as the medical-vocational guidelines, or as lawyers call them, the “Grid Rules.” The older you are and the fewer work skills you have, the easier it is to win SSD benefits.

STEP SIX - SSI ONLY:

In order to receive SSI benefits, not only do you have to prove that you meet the medical requirements but you also have to meet the “non-medical” requirements. What is that? Money essentially. Since SSI is considered a type of welfare benefit, it has very strict and very low income and assets limitations. Those rules can also be complicated.

It isn’t easy to win Social Security benefits. Likewise, the five step review process is frustrating for most people. But having an attorney throughout the review process can make it easier and greatly improve your chances of success. 

Call 248-395-4100 today and speak to an attorney about your case.