DI 22001.001:
Sequential Evaluation of Title II and Title XVI Adult Disability Claims
Effective Dates: 02/21/2018 - Present- Effective Dates: 06/19/2018 - Present
- 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:
- * 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.
- * 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)?
- * If yes, the claimant is not disabled.
- * 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?
- * If no, the claimant is not disabled; and
- * 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 25205.005 Evidence of a Medically Determinable 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?
- * If yes, the claimant is disabled; and
- * If no, the sequential evaluation continues.
- For a detailed explanation of how to determine whether impairment severity meets or medically equals a listing, see:
- * DI 24508.005 Impairment Meets a Listing
- * DI 24508.010 Impairment or Combination of Impairments Equaling a Listing — Medical Equivalence
- * DI 34001.001 Listing of Impairments — Purpose, Parts, and Use
- 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:
- * Does the claimant retain the capacity to perform any PRW as he or she actually performed it?
- * 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?
- * If yes, the claimant is not disabled.
- * If no, the claimant is disabled.
- For detailed explanations of how we evaluate step five, see:
- * DI 25015.000 Ability to Perform Other Work
- * DI 25020.000 Functional Limitations and Their Effects on Ranges of Work
- * DI 25025.000 Medical-Vocational Guidelines
- E. Exhibit of Adult Initial Sequential Evaluation process
- See the graphic illustrating the Steps in Adult Initial Sequential Evaluation.
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