DENIALS AT EACH STEP AND WHAT THEY MEAN

A Social Security disability claim can be denied at steps 1 through 5 of the sequential decision-making process.  While denials at steps 4 and 5 are the most common, denials can happen at any stage of the process.  Here's why each denial happens.

STEP 1:  You could be denied if you are currently working at the level of substantial gainful activity (SGA).  This happens if you currently have wages or self-employment income of at least $1,180 per month.  You can't work and receive Social Security disability benefits at the same time.  So a Step 1 denial is based on working.

STEP 2:  You do not have a medically determinable impairment that has lasted for at least 12 consecutive months, is expected to last for at least 12 consecutive months OR to end in death.  If your medical impairment is not expected to last a full year, your claim will be dismissed here at Step 2.

STEP 3:  There usually are no denials at Step 3; however, this step determines two things that set you up for steps 4 and 4.  First, it is decided here whether you meet a published Listing.  Second, your Residual Functional Capacity (RFC) is decided here at Step 3.  The RFC is the most you are capable of doing in terms of work-like activity.

STEP 4:  You can be denied if it is determined that you are able to perform any of your Past Relevant Work (PRW).  PRW is any full-time job you have held within the 15-year period prior to filing for Social Security disability.  If you are able to perform any of those jobs, you will be denied at Step 4.

STEP 5:  A denial here means that you cannot perform any of you past work but there are other jobs in the US economy that you could perform.  This is really where most denials take place, especially for individuals who are under age 50 and cannot meet a grid rule.  So, by the time you get to step 5, you must be unable to perform any kind of full-time job, even a simple unskilled sedentary job, in order to get benefits.

What's the Best Way to Avoid a Denial?

First, have your case evaluated by someone who knows the system before your hearing.  An experienced attorney/advocate can look at your case and probably tell what's likely to happen at each step.

Second, be sure you prove the severity of your medical impairment(s) with objective medical evidence.  What your doctor says is what is really important. This also happens before the hearing takes place by making sure Social Security has all of your pertinent medical records.

Third, have your appeal prepared by competent legal counsel.  If you simply trust to luck, luck will usually let you down.  Your attorney/representative will look at each of the five steps ahead of time and try to go in with a winning strategy at each step.
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