STEP ONE simply determines if an individual is "working (engaging in substantial gainful activity)" according to the SSA definition. Earning more than $830 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.
STEP TWO implies that the multiple sclerosis (MS) disability must be severe enough to significantly limit one’s ability to perform basic work activities needed to do most jobs. For example, the SSA must be able to determine that some or all of the activities below have been compromised as a result of the disability:
- walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling;
- seeing, hearing or speaking;
- understanding/carrying out and remembering simple instructions;
- use of judgment;
- responding appropriately to supervision, co-workers and usual work situations;
- dealing with changes in a routine work setting.
STEP THREE lists MS under the category of impairments known as neurological. There are several ways to satisfy the listing criteria for MS: (A) Significant and persistent disorganization of motor function in two extremities, resulting in sustained disturbance of gross and dexterous movements or gait and station; (B) Visual impairments with either best corrected vision in the better eye of 20/200 or less, marked contraction of peripheral visual fields to 10° or less from the point of fixation, or visual efficiency in the better eye of 20% or less; (C) Organic mental disorder with marked restrictions; and (D) Significant, reproducible fatigue of motor function with substantial motor weakness on repetitive activity, demonstrated on physical examination, resulting from neurological dysfunction in areas of the central nervous system known to be pathologically involved by the multiple sclerosis process. For example, an individual requiring assistive devices to ambulate secondary to MS would be a listing level impairment.
STEP FOUR explores the ability of an individual to perform work done in the past despite the MS disability. If the SSA finds that a person can do past work, benefits are denied. If the person cannot, then The Process proceeds to the fifth and final step.
STEP FIVE looks at age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. To determine disability, the SSA enlists vocational rules, which vary according to age. For example, if a person is:
- Under age 50 and, as a result of the symptoms of MS, unable to perform what the SSA calls sedentary work, then the SSA will reach a determination of disabled. Sedentary work requires the ability to lift a maximum of 10 pounds at a time, sit six hours and occasionally walk and stand two hours per eight-hour day.
- Age 50 or older and, due to the MS disability, limited to performing sedentary work but has no work-related skills that allow the person to do so, the SSA will reach a determination of disabled.
- Over age 60 and, due to the MS disability, unable to perform any of the jobs performed in the last 15 years, the SSA will likely reach a determination of disabled.
- Any age and, because of multiple sclerosis, has a psychological impairment that prevents even simple, unskilled work, the SSA will reach a determination of disabled.