THE 5-STEP SEQUENTIAL PROCESS IN DISABILITY HEARINGS

There are 5 steps that an administrative law judge must use in determining whether a claimant is disabled under Social Security law.  The 5 steps are sequential.  The claimant must satisfy step one before going on to step 2, etc.  Here are the 5 steps, outlined in brief form.

Step 1.  Is the claimant engaging in substantial gainful activity under 20 CFR 404.1520(B)?

Step 2.  Does the claimant have a medically determinable impairment that is severe or a combination of impairments that is severe under 20 CFR 404.1520(C)?

Step 3:  Does the claimant's impairment(s) meet or medically equal an impairment listed in 20 CFR Part 404, Subpart P, Appendix I (commonly called "the listings")?  If so, the claimant is disabled.  If not, the analysis proceeds to the next step.  Here, the judge must determine the claimant's residual functional capacity (RFC), according to 20 CFR 404.1520(e) and SSR 96-8p).

Step 4:  Does the claimant have the residual functional capacity to perform the requirements of past relevant work, as defined in 20 CFR 404.1520(f)?  Only work performed at substantial gainful activity level during the past 15 years may be considered.  If the claimant has no past relevant work experience or if he/she is not able to perform any past relevant work, the analysis proceeds to the fifth step.

Step 5:  Using the same RFC that was used in Step 4, is the claimant able to perform any other work, considering his/her age, education and work experience.  If the claimant is able to do other work, he/she is not disabled.  If not, the claimant will be found disabled.

As we can see, a disability hearing runs on a very structured and preordained course. An experienced disability representative knows exactly what must be proven to win the case.  That is not to say that the judge has no discretionary powers.  The judge may, for instance give great weight to one medical opinion and little weight to another doctor's opinion.  The judge may find that the claimant's testimony is credible or not.  Different judges will run their hearings in different ways; however, all must address the five step process as outlined here.

I hope claimants can also see that this is probably not a process that they want to handle without representation.  Appearing at a hearing without representation may actually delay the case because many judges will advise the claimant of their right to get representation and "recommend" that the hearing be delayed until adequate representation is obtained.  Claimants may, of course, insist on non-representation and appear on their on behalf.  The question is, would that be the wise thing to do?

The Forsythe Firm practices exclusively in the field of Social Security representation from its offices in Huntsville, Alabama.  You may contact them at (256) 799-0297 or www.forsythefirm.com


Comments

Post a Comment

Popular posts from this blog

GETTING MONEY FROM SSDI

SSDI stands for Social Security Disability Insurance .  When you first began working, the Government deducted a percentage of your wages, called a FICA tax.  This continued as long as you worked, in most cases.  This money was matched by your employer and set aside in a government trust fund to help you if you later became disabled and could not work. SSDI is a type of government sponsored insurance program, usually called "Social Security disability insurance."  To get benefits out of SSDI, you must prove  that you have a medical disability so severe that you cannot work any full-time job; that this disability has lasted, or is expected to last, for at least 12 consecutive months. That sounds simple but Social Security has made it rather difficult to prove that you are disabled.  One reason is that their definition of 'disability' is so strict.  You usually must prove that you cannot perform even simple, unskilled work at the sedentary (sitting) leve
Read more

POST HEARING EVIDENCE

Many people assume that a Social Security disability case is over when the hearing has been held.  This isn't always the case.  Often there is post hearing work that should be done to achieve the best chance of a favorable decision. Everyone at a disability hearing works under pressure.  This includes the claimant, the representative, the vocational expert and even the administrative law judge.  Hearings are generally limited to less than one hour.  The judge will ask questions that place the claimant under stress to answer correctly.  The representative or attorney will be asked to respond to procedural issues or points of law that place him or her under pressure.  The judge must constantly conduct the hearing so that it follows Social Security laws, rules and regulations.  Further, the judge must form accurate hypothetical questions for the vocational expert based on the medical and vocational evidence in the file and upon the claimant's testimony.  The vocational expert th
Read more

PARTIALLY FAVORABLE DECISIONS ON DISABILITY

You attended a hearing on your Social Security disability claim.  A few weeks later, you receive a Notice of Decision in the mail that says you have received a Partially Favorable decision.  Does this mean that you are only partially disabled, not fully disabled? ANSWER:  No.  Social Security does not make awards for partial disability.  You are either disabled or not disabled.  There is no such category as "partially disabled" within Social Security law. A "partially favorable" decision means that the administrative law judge has found you to be disabled.  However, he or she has changed some material fact in your application.  Most often, this change involves the established onset date--the date you were found to have become disabled.  For example, in your application you may have alleged that you became disabled on June 1, 2012.  After reviewing the facts of the case, the judge may have decided that you did not become disabled until September 1, 2012.  Theref
Read more