TN 5 (02-16)

DI 22001.001 Sequential Evaluation of Title II and Title XVI Adult Disability Claims

Citations:

20 CFR 404.1520 and 416.920

A. The application of adult sequential evaluation of disability

The evaluation of disability applies to the following:

  • adult initial disability claims under title II or title XVI of the Social Security Act;

  • age 18 redeterminations under title XVI; and

  • title II disabled minor child (DMC) cases.

NOTE: When a case includes evidence of a visual impairment and requires a statutory blindness determination, see Statutory Blindness Cases - Development, Evaluation, and Processing Issues in chapter DI 26000.000.

B. Requirement to follow sequential evaluation steps in order

Use the five-step sequential evaluation process detailed in DI 22001.001D in this section to determine if a claimant is entitled to disability benefits. Consider each step in this process in numerical order except where policy specifically permits a deviation.

EXCEPTIONS:

  1. When policy permits an expedited vocational assessment, you may consider step five prior to evaluating step four. See details for the Expedited Vocational Assessment in Steps 4 and 5 of Sequential Evaluation in section DI 25005.005.

  2. In certain situations, policy permits adjudicators to make a fully favorable step five determination without considering step three. For related policy, see subsection DI 24515.020C.9.

C. The endpoint of the sequential evaluation

If you can determine the claimant is or is not disabled at a given step, the sequential evaluation ends. Make the determination and do not go to the next step.

D. The steps of adult sequential evaluation of disability

1. Step one considers work activity

Is the claimant engaging in substantial gainful activity (SGA)?

  1. If yes, the claimant is not disabled.

  2. If no, the sequential evaluation continues.

For an explanation of SGA evaluation, see:

  • DI 24001.010 Effect of SGA on Disability Status

  • DI 24001.015 SGA and the Sequential Evaluation Process

  • DI 24001.025 Substantial Gainful Activity (SGA) Earnings Guidelines and Evaluation of Earnings and Income

2. Step two considers whether the claimant has a severe impairment(s)

Does the claimant have a medically determinable impairment (MDI) (or combination of MDIs) that is both severe and meets the duration requirement?

  1. If no, the claimant is not disabled; and

  2. If yes, sequential evaluation continues.

For detailed explanations of these considerations, see:

  • DI 24505.001 Individual Must Have a Medically Determinable Severe Impairment

  • DI 24505.005 Evaluation of Medical Impairments that are Not Severe

  • DI 24515.065A Need to establish the existence of a medically determinable physical or mental impairment

  • DI 25505.030C Severity and the duration requirement

3. Step three considers whether the claimant’s impairment(s) meets or medically equals a listing in appendix 1

Does the claimant have an impairment(s) that meets a listing, or is medically equal to a listing in appendix 1, and meets the duration requirement?

  1. If yes, the claimant is disabled; and

  2. If no, the sequential evaluation continues.

For a detailed explanation of how to determine whether impairment severity meets or medically equals a listing, see:

NOTE: Before the sequential evaluation continues, we determine the claimant’s residual functional capacity (RFC). For RFC assessment instructions, see Residual Functional Capacity (RFC) in subchapter DI 24510.000.

4. Step four considers whether the claimant’s impairment(s) prevents performance of Past Relevant Work (PRW)

When comparing the RFC with the physical and mental demands of the claimant’s PRW, we must consider two questions:

  1. Does the claimant retain the capacity to perform any PRW as he or she actually performed it?

  2. Does the claimant retain the capacity to perform any PRW as generally performed in the national economy?

    • If the answer to either question is yes, the claimant is not disabled.

    • If the answer to both questions is no, the sequential evaluation continues.

For a detailed explanation of how we consider whether a claimant has the residual functional capacity to do PRW, see Capacity to Do Past Relevant Work in subchapter DI 25005.000.

NOTE: Consider the Special Medical Vocational Profiles after evaluating step four and before evaluating step five. If one of the special medical-vocational profiles applies, the claimant is disabled and the sequential evaluation ends. For a detailed explanation of this policy, see Special Medical-Vocational Profiles in section DI 25010.001.

5. Step five considers whether a claimant can make the vocational adjustment needed to perform other work

Does the claimant have the ability to make an adjustment to any other work, considering the claimant’s RFC, age, education, and work experience?

  1. If yes, the claimant is not disabled.

  2. If no, the claimant is disabled.

For detailed explanations of how we evaluate step five, see:

E. Exhibit of Adult Initial Sequential Evaluation process

See the graphic illustrating the Steps in Adult Initial Sequential Evaluation.

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To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0422001001
DI 22001.001 - Sequential Evaluation of Title II and Title XVI Adult Disability Claims - 02/18/2016
Batch run: 02/18/2016
Rev:02/18/2016