Legalmania, I hope you don’t mind if I jump in. In my former life I was accused of sleeping with 24 CFR and the Federal Register under my pillow. It was my role to read and develop company (and occasionally industry-wide) policy, as it applied to changes to the CFR and other regulatory handbooks. That meant re-writing into language that could be understood by those who had to implement it. So, thought maybe I could make this a little easier to understand as well.

The five-step process starts with the Social Security (SSA) office. At Step One SSA determines if you are ‘technically’ eligible. If SSA determines you are technically eligible, your file will be forwarded to the Disability Determination Service (DDS) for your State. The DDS determines if you are “medically” eligible, by applying Steps Two through Five.

Step One – Substantial Gainful Activity (SGA): Are you participating in ‘Gainful’ work activity? If your earnings are below the SGA limit (for 2010 it is $1,000), you are not participating in ‘Gainful’ work activity. But are you participating in ‘Substantial’ work activity? If you are working and earning less than $1,000, the answer to this will generally be No. But if, for example, you are working for your friend 40-hours a week, but only getting paid $500/month, most likely your work activity will be considered ‘Substantial’. Also keep in mind this only applies to ‘earned’ income – money you get from working. It does not apply to ‘unearned’ income – money you get from sources like TANF (welfare), SSA for children, annuities, etc.

If you are earning less than $1,000 and are not participating in substantial work activity, your file will be sent to the DDS to determine medical eligibility. If you are participating in Substantial Gainful Activity, you will be denied at this step.

Step Two – Do you have an impairment (or combination of impairments) that ‘severely’ limits your ability to participate in Substantial Gainful Activity? At this step your medical records will be reviewed to determine if you have a physical or mental impairment that has been established by clinical findings, symptoms and/or laboratory tests - are you being treated by a doctor? And that impairment must limit your ability to function in a job. Your own statement of symptoms and inability to find work would not qualify as a severe impairment.

If you have a severe impairment, the DDS examiner will move on to Step Three. If the DDS examiner determines you do not have a severe impairment, you will be denied at this step.

Step Three – Is your impairment listed in the Blue Book, or does a combination of impairments meet the criteria of one of the impairments. And, is your condition expected to last longer than 12 months, or result in death. For example: It would probably surprise you to know that most cancers are not a listed impairment. But, the treatment can cause other symptoms, like neuropathy; or the medications may make it difficult to think, or shortness of breath may make it difficult to remain standing or walking, etc. The combination of those factors may meet the criteria for impairment. Before submitting your application, I would advise you read through the entire Blue Book, making note of every condition that applies to you. The combination of impairments may meet the criteria of impairment, where one impairment alone may not.

(Note: I have the Blue Book, other handbooks, and all required forms, in fillable/saveable format available on my blog at the link in my signature)

If the DDS examiner determines your impairment (or combination) meets the criteria established in the Blue Book, he/she will move on to Step Four. If not, you will be denied at this step.

Step Four – Can you do any jobs you did in the past 15 years? The purpose of Step Four is to determine if your impairment prevents you from performing any of the jobs you did during the past 15 years. When you receive the form ‘Adult Function Report (SSA-3373-BK)’ in the mail, you will know you are at Step Four. It is a 10-page form that asks you questions about how you function in daily living, and about your duties in your prior jobs. You will probably also get a Pain Questionnaire or Fatigue Questionnaire. Your answers will tell the examiner if you can do any past jobs with your current limitations. (This form is also available for download at my blog)

If the DDS examiner determines you are not able to do any past jobs, he/she will move on to the final step – Step Five. If, however, the examiner determines you are able of performing a job you did in the past 15 years, you will be denied at this step.

Step Five – The final step - Can you do any other jobs? Here the examiner will determine if you are capable of doing any job. Your age, education and past work experience factor into this decision. If you are under 50, the examiner will compare your abilities with jobs available in the national economy. If you were once a plumber, are you now capable of running a cash register at the local convenience store? If you are over 50, the examiner will use The Grid.

This is the final step. The examiner either determines you are unable to do any work, and you are approved. Or, the examiner determines you can run a cash register, and you are denied.

Good luck to anyone applying.