What Does Social Security Mean by a “Severe” Impairment? The Sequential Process

What Does Social Security Mean by a “Severe” Impairment?

Understanding Step Two of Social Security’s Five-Step Sequential Evaluation Process

Part Three of Powell & Denny’s Guide to Social Security Disability Benefits

At Step Two of the Five Point Sequential Evaluation Process, Social Security asks Do you have one or more medically determinable impairments that significantly limit your ability to perform basic work activities?

Notice what the Administration is not asking.  It is not asking whether you are permanently disabled.  It is not deciding whether you can ever work again.  It is not deciding whether you’ll ultimately receive disability benefits.

Step Two simply determines whether your medical conditions are serious enough to continue evaluating your claim.

Where We Are in the Disability Process

The Powell & Denny Guide to Social Security Disability

✓ Part One
How Social Security Decides Disability

✓ Part Two
Can You Work While Applying?

═══════════════════════════════

► PART THREE
What Is a Severe Impairment?

═══════════════════════════════

Part Four
The Listings

Part Five
Residual Functional Capacity

Part Six
Other Work

Part Seven
Chronic Pain

Part Eight
Burden of Proof

What Is a “Medically Determinable Impairment?”

Before Social Security considers whether an impairment is severe, it must first determine that the impairment actually exists.  That sounds obvious, but it is an important distinction.

Simply telling Social Security that you hurt is not enough.  Instead, there must be medical evidence showing that your symptoms are connected to a diagnosable physical or mental condition.

For example:

• Degenerative disc disease
• Osteoarthritis
• Rheumatoid arthritis
• Diabetes
• Heart disease
• Multiple sclerosis
• Depression
• Anxiety
• Schizophrenia
• Fibromyalgia
• Complex Regional Pain Syndrome (CRPS)

These—and many other conditions—may qualify as medically determinable impairments when supported by appropriate medical evidence.

Once Social Security determines that an impairment exists, the next question becomes whether it is severe.

“Severe” Doesn’t Mean What Most People Think

This is one of the biggest misunderstandings in disability law.  When most people hear the word “severe,” they picture someone confined to a wheelchair or hospitalized with a life-threatening illness.

That is not what Step Two is asking.

Instead, Social Security asks whether your impairment significantly limits your ability to perform basic work activities.  Those activities include things like:

• Walking
• Standing
• Sitting
• Lifting
• Carrying
• Reaching
• Using your hands
• Understanding instructions
• Concentrating
• Remembering information
• Interacting appropriately with others
• Maintaining regular attendance at work

If your medical condition significantly interferes with those basic activities, your claim will usually move to the next step.

Recommended Reading: What is a Severe Impairment?

Think of Step Two as a Security Checkpoint

Medical Condition
│
▼
Is the condition medically documented?
│
No──┴────► Claim cannot realistically continue
│
Yes
▼
Does it significantly affect basic work activities?
│
No──┴────► Not a severe impairment
│
Yes
▼
Continue to Step Three

Step Two is designed to screen out claims involving only slight limitations, it is not intended to determine who ultimately wins or loses a disability claim.

Why Multiple Medical Problems Matter

Many people focus entirely on what they believe is their worst medical condition, but that is a mistake.

Imagine two people.  The first has chronic back pain.  The second has:

• chronic back pain;
• diabetes;
• obesity;
• depression; and
• anxiety.

None of those conditions, standing alone, may completely prevent someone from working.  Together, however, they may significantly affect nearly every aspect of employment.

That is why Social Security evaluates all medically determinable impairments—not just the diagnosis you think is most important.

Powell & Denny Practice Tip

Don’t make the mistake of telling Social Security only about your “main problem.”  Many successful disability claims are based upon the combined effects of several medical conditions rather than one catastrophic diagnosis; and always include the side effects of any medications you have to take.

Recommended Reading: How the Side Effects of Medication Can Affect your Claim

Temporary Problems Usually Aren’t Enough

Another important part of Step Two is duration.  Not every injury qualifies for disability benefits.  A broken arm expected to heal within a few months may temporarily prevent someone from working, but that doesn’t necessarily make the person disabled under Social Security’s rules.

Instead, Social Security generally looks for medical conditions expected to last at least twelve months or result in death. The important question is not simply how severe the condition is today, but whether the condition is expected to produce long-term limitations.

What About Pain?

Many people worry because their pain seems much worse than their medical records appear to show.  That concern is understandable.  Pain is one of the most common reasons people apply for disability benefits.

Fortunately, Step Two is not where Social Security decides whether your pain is disabling.

Instead, Step Two simply determines whether you have one or more medically determinable impairments capable of producing your symptoms.  Later in the disability process, Social Security must evaluate how pain—and other symptoms such as fatigue, dizziness, medication side effects, depression, and anxiety—affect your ability to sustain full-time employment.

We’ll devote an entire article in this series to that subject because it is one of the most misunderstood areas of disability law.

The Bottom Line

Step Two is often misunderstood because people focus on the word “severe.”

In reality, Social Security is simply asking whether your medically documented impairments significantly limit your ability to perform basic work activities.

If they do, your claim usually moves forward.

The next question becomes one of the most talked-about subjects in disability law:

Does your condition meet or equal one of Social Security’s Listings?

Many people believe that failing to meet a Listing means they automatically lose their disability claim.

Fortunately, that’s simply not true.

We’ll explain why in our next article.

Recommended Reading

Continue the Powell & Denny Guide to Social Security Disability

✓ Part One – How Social Security Decides Disability

✓ Part Two – Can You Work and Still Receive Social Security Disability Benefits?

➡ Coming Next – Do You Have to Meet a Listing to Win Your Disability Claim?

You may also enjoy:

• Residual Functional Capacity (RFC): Where Many Disability Cases Are Won or Lost
• Can Chronic Pain Qualify You for Social Security Disability Benefits?

Coming Next…

Do You Have to Meet a Listing to Win Your Disability Claim?

One of the biggest myths in Social Security Disability law is that you must “meet a Listing” to receive benefits.

The truth is that many successful disability claims never meet a Listing at all.

In the next article, we’ll explain:

• What the “Blue Book” really is.
• What a Listing actually means.
• What “medical equivalence” is.
• Why many approved claims never satisfy a Listing.
• Why Step Three is only one part of the disability process.

By the end of the next article, you’ll understand why so many people mistakenly believe they have lost their disability claim—when, in reality, the most important part of their case has not even begun.