The Sequential Evaluation Process In SSDI Claims

In evaluating whether a claimant is entitled to Social Security Disability benefits, an administrative law judge (ALJ) will evaluate the claimant using a five-step process. This is a "sequential" process, meaning that the judge will ask the questions in order. If the answer to the question at any step indicates that a claimant is or is not disabled, the ALJ will stop.

The questions are:

Is the claimant engaged in substantial gainful activity? (If so, the claimant cannot be disabled).

Does the claimant have a severe impairment? (This means that the impairment must limit the claimant's ability to work.) If the claimant has a severe impairment, the ALJ determines whether the impairment is so severe as to meet the requirements of a "listing." (The listings, compiled by the Social Security Administration, describe impairments so severe that sufferers are automatically considered disabled, without considering the claimant's vocational ability to work.)

If the claimant has a severe impairment that does not meet the requirements of a listing, does it prevent the claimant from returning to prior employment? (If the impairment does not prevent the claimant from returning to prior employment, the claimant is not disabled. Prior employment refers to past relevant work — generally work done for a significant period of time within the past 15 years.)

If the impairment does not meet the requirements of a listing, but does prevent the claimant from performing prior employment, can the claimant perform other work available in the national economy? (If so, the claimant is not disabled. This requirement is discussed under vocational evidence.)

The claimant must demonstrate items one through four on the list above. If the ALJ proceeds through the process to step five, then the Social Security Administration must demonstrate that the claimant can perform other work. The Social Security Administration uses a vocational expert at the hearing to discuss whether the claimant can perform his or her prior job or any other employment in the national economy.

If the ALJ decides against the claimant, the claimant may appeal to the Appeals Council within 60 days of the date of the ALJ's decision.

Vocational Evidence/The Grids

The last step of the sequential evaluation process requires a consideration of the ability to work if a claimant cannot return to prior employment. The ALJ must consider vocational evidence on this issue.

The Social Security Administration has adopted a set of regulations (known as the grids) to help make these determinations. The grids apply age, education, work history and physical ability to work to a claimant, then automatically reach a conclusion about whether the claimant can work. (You can find more information about the grids on the Social Security Administration's website.) If the ALJ determines that a claim fits within the grids, the ALJ will just look at the grids and reach the result they compel. No further evidence is required. If the claimant does not fit within the grids, however, the administrative law judge may also have a vocational consultant present to testify as to what work, if any, the claimant might be capable of doing.

The vocational expert's role is to clarify issues concerning the claimant's work experience. This expert is asked by the judge to classify the claimant's past job(s) in terms of skill and exertion level. Skill level may range from unskilled to semiskilled to skilled. Exertion levels include sedentary, light, medium and heavy. The vocational expert is also asked whether the claimant obtained job skills in previous work experience that are transferrable to other jobs.

Frequently, an administrative law judge will ask the vocational expert a hypothetical question. Careful attention should be paid to this question to ensure that it correctly states the facts in the claimant's case. The vocational expert should be asked: "Assuming the disabilities and restriction testified to by the claimant at the hearing are true, are there jobs available that the claimant is capable of doing?"

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