expected to last for a continuous period of not less than 12 months.” In addition, individuals under the age of 18 are considered disabled if they have a medically determinable physical or mental impairment, which results in marked and severe functional limitations, and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.
Five-Step Sequential Evaluation Process
For adults applying for SSDI or SSI benefits, SSA uses a five-step sequential evaluation process to determine whether a claimant is disabled (see Figure 1-1).3 This process is different for children under age 18.
At Step 1, SSA determines whether the claimant is engaging in substantial gainful activity. If not, the claim progresses to Step 2 to determine whether the claimant has a severe impairment that significantly limits the claimant’s ability to perform basic work activities (e.g., standing and sitting). If the claimant is found to have a severe impairment, then SSA determines whether it satisfies the medical condition criteria found in the Listing of Impairments, also referred to as the Listings. This serves as an
dence consisting of signs, symptoms, and laboratory findings, not only by a person’s statement of symptoms.
SSA has three additional ways to expedite decisions: (1) flagging TERI (TERminal Illness) cases for expedited processing; (2) using a predictive model to identify QDD (Quick Disability Determination) cases that are highly likely to be allowed and processing them within 20 days; and (3) using CAL (Compassionate ALlowances) to approve cases with certain diagnoses—either terminal (e.g., gallbladder cancer) or permanently disabling (e.g., mixed dementia).