SEQUENTIAL ANALYSIS Flashcards
SEQUENTIAL ANALYSIS GENERALLY
Sequential Analysis starts with a series of 5 questions associated with the client’s condition. If at any point in the sequential analysis process a case is determined not disabled, the evaluation ends. Each question is designed to rule out a claimant’s eligibility to receive benefits.
STEP ONE
DOES THE CLAIMANT HAVE A SEVERE MEDICALLY DETERMINABLE IMPAIRMENT THAT IS PREVENTING WORK?
Within step one of SA, if the answer is no the DDS Examiner will write a denial decision based on the reasoning - there is no significant impairment that reduces the claimant’s ability to perform work. Or that the claimant is still working at SGA level if this is the case. If the answer to step one is yes, the Examiner will move to Step 2 in the SA process. A disability advocate follows the same SA steps as the DDS Examiner in evaluating a claim.
The issues in step one are impairment severity, work activity, and SHA. If the claimant has a severe impairment and is not currently working at (Substantial Gainful Activity - SGA), their case will be moved to the next step in SA.
STEP TWO
WILL THE IMPAIRMENT LAST FOR TWELVE CONTINUOUS MONTHS?
If the answer is no, the case is denied based on duration. SSA’s definition of duration is that the impairment must last or be expected to last for twelve continuous months. A yes answer moves the case to Step 3.
The key issue in step 2 of SA si duration. The claimant’s impairment must last or be expected to last twelve continuous months to meet the duration requirement.
STEP THREE
DOES THE IMPAIRMENT MEET OR EQUAL THE MEDICAL LISTING?
The medical listing is a book used by SSA to determine the degree of impairment severity. If a claimant’s condition meets or equals this listing, the case will merit an immediate allowance. If the impairment does not meet or equal the listing, the DDS Examiner moves to Step Four of sequential analysis.
The key issues in step 3 of SA are meeting or equaling the medical listings. If a claimant meets or equals a listing, he is allowed. If he does not meet or equal a listing, he moves to step four of SA.
STEP FOUR
CAN THE CLAIMANT STILL DOE THEIR PAST WORK?
If the answer to this SA question is yes, then the case is denied. The claimant is told that they can return to the duties of their past work as the reason for the denial. If the answer is no, the DDS Examiner moves to the final SA step.
The key issue in step 4 of SA asks, can the claimant perform his past work? Past work is defined as the primary work performed by a claimant over the past 15 years. To determine if the claimant can do his past work, you must perform a process called vocational analysis (VA). If the claimant is unable to perform past work, he moved to step five of SA.
STEP FIVE
CAN THE CLAIMANT PERFORM OTHER LESS DEMANDING WORK?
If the answer is yes, the case will be denied. The reason for the denial is their remaining ability to adjust to other less demanding work.
If the answer is no, the case will be allowed based on the claimant’s inability to perform even less demanding types of work. The majority of adult disability cases are allowed or denied based on SA Step Five.
Sequential Analysis step four and five are called vocational steps. They are both based on a claimant’s remaining ability to do his past or other less demanding work. All decisions based on SA steps four or five are referred to as medical-vocational decisions based on medical and vocational factors. Medical vocational means that medical and work were factors in making the final decision.
The key issue in step 5 of SA asks, can the claimant do other less demanding work? Other less demanding work is defined as simlar or other work that the claimant might be able to perform despit his impairment The work must not require capabilities the clainant no longer has or ever possessed. To determine if the claimant can do less demanding work, you must perform a process called vocational analysis (VA).
THE CASE DECISION
If the case decision is a denial, you will either drop the case or begin the appeal process depending on the case circumstances. A case denial can teach you a lot about what SSA thinks about a case. It can also provide yo with insights into possible strategies that might reverse the decision.
NOTIFICATION OF DENIAL
A client is notified of a case decision b mail on the initial and first two appeal levels. You can ask the client the reason for the denial if he knows. The claimant is sent a letter called a Personalized Denial Letter (PDN) explaining the reason for the denial. you should request a copy of this PDN notice from both SSA and the client with every case you accept.
DETERMINING THE REASON FOR THE DENIAL - STEP 1?
The impairment is not severe, and it does not prevent work.
DETERMINING THE REASON FOR THE DENIAL - STEP 2?
The impairment does not meet the 12-month duration requirement.
DETERMINING THE REASON FOR THE DENIAL - STEP 3?
The impairment does not meet or equal the medical listings.
DETERMINING THE REASON FOR THE DENIAL - STEP 4?
The claimant can do past work.
DETERMINING THE REASON FOR THE DENIAL - STEP 5
Claimant can do other less demanding work
