When you apply for disability benefits, the Social Security Administration (SSA) will first look to see if your medical condition meets or equals the requirements of one of its impairment "listings." A listing is a medical condition that the SSA has concluded is so severe that it warrants automatic approval. If your medical condition meets all the requirements of a listing, you will be approved.
However, most people aren't approved for disability this way. Instead, the majority of applicants will have their claims decided based on whether they qualify for a medical-vocational allowance.
To see if you qualify for disability under a medical-vocational allowance, the SSA has to first figure out your residual functional capacity (RFC). The SSA will then take your RFC and decide 1) whether you can do your past job and 2) whether there is any other work you can do in your area or in the United States. If the answer is no to both of these questions, you will be approved for benefits under a medical-vocational allowance.
Your RFC is the most work you can do on a regular and sustained basis. To decide your RFC, the SSA looks at the medical evidence in your file, any notes or records from your doctors, and the results of any exams you have had by an SSA doctor. The SSA will use this information to prepare a detailed assessment of your ability to do certain work-related activities like sitting, standing, walking, lifting, and carrying. Based on the results of the assessment, you will be assigned an RFC for sedentary, light, medium, or heavy work.
The higher the RFC, the more difficult it is to get approved. This is because the SSA will conclude that the higher your RFC, the greater range and number of jobs are out there that you can do.
The SSA first looks at the tasks required in your old job to see if you have the RFC to still do it. If you have the RFC to do your old job, you will be denied right away. On the other hand, if the SSA decides you don't have the RFC to do your old job, it will go on to the next step and decide if there is other work you can do.
For example, say your past work was "light," meaning you had to stand and walk for up to six hours in an eight hour day and lift ten pounds frequently (and 20 pounds occasionally). If you were given an RFC for sedentary work only, then you can't do your old job, and the SSA will go on to the next step.
On the other hand, if your past work was as a secretary, which is generally a sedentary (sit-down) job, and the SSA concludes you have still have the RFC for a sit-down job, you will be denied unless you can prove that you have other disability-related limitations (such as mental limitations or an inability to attend work regularly because of frequent sickness) that prevent you from doing your past work.
If you can't do your old job, the SSA has to next decide if there is other work you can do in the national or local economy; if there is, you will be denied benefits. Only if the SSA concludes you can't do any other job that exists in significant numbers will you be approved.
At this stage, your past work experience becomes especially important, because the SSA will look at it to see if you learned any special skills that could be transferred to a new job.
Here is an example of how an applicant might be denied at this stage.
Generally, if you are 50 or older, it is easier to get approved for Social Security disability (or SSI) benefits. (This may not be true, though, if you have significant job skills, which we discuss below).
If you are over 50, the SSA will use what disability lawyers call the grid rules, or grids, to decide if you can be approved under a medical-vocational allowance. The grids are a series of tables that say when applicants are disabled or not-disabled, based on their RFC, age, education level, skill level of their past work, and whether they learned any skills in their old job that they could use in a new position.
Here is an example of how the SSA might use the grids to decide a claim.
Even though getting approved under a medical-vocational allowance can be challenging, it is possible. In fact, most people are approved for disability benefits this way. It is key that you provide the SSA with as much accurate information about your past jobs as you can; this will help ensure that the SSA classifies your past work correctly. Also, make sure you give the SSA all of your relevant medical information as early in the application process as possible. Most important, ask your doctor to fill out an RFC form for you. Learn more about RFCs here.
Don't be discouraged if you are initially denied; this happens to most applicants because they don't understand the process and what information is needed. Make sure you file your appeal on time and that you keep the SSA updated with all your relevant medical information.