The Social Security Administration uses a five-step process to decide if you are a disabled person and entitled to Social Security disability benefits:
- You must not be engaging in market-rate paid work; and
- You must have a serious illness or disability; and
- Your impairment must meet the definitions of disabled persons described in the Social Security regulations https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm”, or
- You must be unable to do the work you used to do; and
- You must not be able to do other similar work as you used to be able to do.
There are three special exceptions: (1) over 55 years old with a severe medically determined impairment with less than 11th-grade education and no past substantial work experience; (2) the “worn out worker,” a person with no more than a 6th-grade education who has worked in arduous unskilled labor for over 35 years and can no longer work; and (3) a person with limited education nearing age 60 who has worked for 30 years but is not earning at the substantial gainful activity level and can no longer work.
You will not be found to be a disabled person and eligible for Social Security disability benefits if:
- Without justification, you don’t follow prescribed treatment. For example, you would be justified in not following prescribed treatment if you can show that the treatment would not help you get back to work.
- Drug or alcohol addiction. You would not be considered eligible for benefits unless the SSA determined that you would be impaired even if you stopped misusing alcohol or drugs.