When the Five-Step Sequential Evaluation Does Not Apply

There are five types of cases where eligibility under the disability guidelines can be determined without completing the regular five-step sequential evaluation process. Cases that fit one of the first three profiles can result in a finding of disability without reference to the Medical-Vocational Guidelines, while cases that fall within the last two categories can be found ineligible even though the sequential disability evaluation process has been completed and SSA has concluded that the claimant is, in fact, disabled.

First Profile (disabled and eligible):

This profile describes a worker:

  • Who has a severe, medically determinable impairment;
  • Who is 55 years old or older;
  • Who has only up to an 11th grade education; and
  • Who has no relevant work experience.

Second Profile (disabled and eligible):

Nicknamed the “worn-out worker,” this is a person:

  • Who has at most a 6th grade education;
  • Who has performed arduous unskilled labor for 35 years or more; and
  • Who is no longer able to perform such labor.

Third Profile (disabled and eligible):

This is an individual:

  • Who is not working at SGA level;
  • Who has committed 30 years or more to unskilled labor, or to a field that requires skills that are non-transferable;
  • Who is no longer able to perform such work due to a severe impairment;
  • Who is near retirement age, i.e., 60 years or older; and
  • Who possesses a limited education.

Fourth Profile (disabled but not eligible)

The first type of ineligible disabled category is a person:

  • Who, without good reason, fails to follow a course of treatment prescribed by his or her own physician that would be “clearly expected to restore” his or her ability to work; and
  • Who has been found otherwise disabled by SSA.

Fifth Profile (disabled but not eligible)

The second type of ineligible disabled category describes a person:

  • Whose drug addiction or alcoholism is considered “a contributing factor material to the determination of disability”;
  • Who has been found to be disabled after considering all impairments, including any that involve drug addiction or alcoholism; and
  • Whose impairments have been reviewed a second time by SSA to consider whether such disability would continue if he or she stopped using drugs or alcohol.

To succeed in your disability claim, you need to know if one of these profiles could potentially apply to your case.  Detroit disability lawyer Marc Shefman has the experience and know-how to determine how SSA is likely to view the facts of your case.  To schedule your free consultation, call our office today.