Sequential Evaluation Process: Advanced Flashcards
Step 1: Determining Substantial Gainful Activity (SGA)
Scenario:
Lisa earns $1,550 per month in 2025. She believes she qualifies for SSDI because she only works part-time.
Question:
Does working part-time automatically qualify Lisa for SSDI?
Answer:
No, part-time work does not automatically qualify her. SSA evaluates earnings against the SGA threshold, which is $1,470/month for non-blind individuals in 2025.
Key Resource: CFR §404.1572 – Definition of SGA.
Key Takeaway:
Earnings above the SGA threshold disqualify claimants, regardless of full-time or part-time work.
Step 1: Determining Substantial Gainful Activity (SGA)
Scenario:
Mark’s earnings are $1,800/month in 2025, but he deducts $500 for IRWEs. He argues that his countable earnings are below SGA.
Question:
Does Mark meet the SGA criteria?
Answer:
Yes, after deducting IRWEs, Mark’s countable earnings are $1,300, below the $1,470 threshold for 2025.
Key Resource: CFR §404.1576 – Impairment-Related Work Expenses.
Key Takeaway:
Countable earnings below the SGA threshold, after IRWEs, do not constitute SGA.
Step 2: Severity of Impairments
Scenario:
Tom has mild back pain and untreated depression. SSA denies his claim, stating neither condition is severe.
Question:
Can the combined effect of Tom’s impairments meet the severity requirement?
Answer:
Yes, if the combination of impairments significantly limits Tom’s ability to perform basic work activities.
Key Resource: CFR §404.1523 – Combining impairments.
Key Takeaway:
Impairments must be severe individually or in combination to satisfy Step 2.
Step 2: Severity of Impairments
Scenario:
Tom has mild back pain and untreated depression. SSA denies his claim, stating neither condition is severe.
Question:
Can the combined effect of Tom’s impairments meet the severity requirement?
Answer:
Yes, if the combination of impairments significantly limits Tom’s ability to perform basic work activities.
Key Resource: CFR §404.1523 – Combining impairments.
Key Takeaway:
Impairments must be severe individually or in combination to satisfy Step 2.
Step 2: Severity of Impairments
Scenario:
Emma’s back injury is severe but has improved after six months of treatment. SSA denies her claim, stating the condition does not meet duration requirements.
Question:
Does Emma’s impairment meet SSA’s duration requirement?
Answer:
No, impairments must last (or be expected to last) at least 12 months or result in death.
Key Resource: CFR §404.1509 – Duration of impairments.
Key Takeaway:
Impairments must meet SSA’s 12-month duration requirement to qualify.
Step 3: Meeting or Equaling a Listing
Scenario:
Sarah claims her epilepsy meets a Blue Book listing. She has weekly seizures but refuses to take prescribed medication.
Question:
Does Sarah’s condition meet the epilepsy listing?
Answer:
No, SSA requires adherence to prescribed treatment to evaluate whether the impairment meets or equals a listing.
Key Resource: CFR §404.1530 – Treatment adherence.
Key Takeaway:
Adherence to prescribed treatments is required to evaluate whether impairments meet a listing.
Step 3: Meeting or Equaling a Listing
David has chronic fatigue syndrome (CFS) but does not meet a specific listing. He argues that his condition equals a listing in severity.
Question:
Can David’s CFS equal a listing in severity?
Answer:
Yes, SSA evaluates whether the condition equals a listing by comparing medical evidence to the severity criteria.
Key Resource: CFR §404.1526 – Medical equivalence.
Key Takeaway:
Conditions can equal a listing in severity without meeting exact criteria.
Step 4: Ability to Perform Past Relevant Work
Scenario:
Emma, a former cashier, claims her arthritis prevents her from performing past work. SSA finds her RFC allows light work.
Question:
Can Emma return to her past relevant work?
Answer:
Yes, if her RFC aligns with the physical demands of her past work as defined by the Dictionary of Occupational Titles (DOT).
Key Resource: CFR §404.1560(b) – Past relevant work.
Key Takeaway:
Step 4 evaluates whether the claimant’s RFC allows a return to past relevant work.
Step 4: Ability to Perform Past Relevant Work
Scenario:
John performed seasonal farm work 16 years ago and argues it counts as past relevant work.
Question:
Does John’s seasonal farm work qualify as past relevant work?
Answer:
No, past work must have been performed within the last 15 years, at SGA levels, and long enough to learn.
Key Resource: CFR §404.1565 – Past relevant work criteria.
Key Takeaway:
Past relevant work must meet recency, SGA, and duration criteria.
Step 5: Ability to Perform Other Work
Scenario:
Tom, 60, has a sedentary RFC with no transferable skills. SSA denies his claim, citing the availability of ticket taker jobs.
Question:
Does Tom’s age and RFC favor a finding of disability under the Grid Rules?
Answer:
Yes, under the Grid Rules, individuals aged 60+ with a sedentary RFC and no transferable skills are typically found disabled.
Key Resource: CFR §404.1569a – Grid Rules and vocational factors.
Key Takeaway:
The Grid Rules favor older individuals with limited RFC and no transferable skills.
Step 5: Ability to Perform Other Work
Scenario:
Lisa, 50, has a high school education and light RFC. SSA identifies jobs in the national economy that match her limitations.
Question:
Does the existence of jobs in the national economy disqualify Lisa at Step 5?
Answer:
Yes, if significant jobs exist in the national economy that Lisa can perform, she is not disabled at Step 5.
Key Resource: CFR §404.1566 – Jobs in the national economy.
Key Takeaway:
Step 5 evaluates whether significant jobs exist in the national economy that the claimant can perform.
