STEP TWO OF THE DISABILITY REVIEW PROCESS

WHAT IS THE SECOND STEP OF THE DISABILITY REVIEW PROCESS?

The SSA uses a five step review process to decide if you qualify for SSD benefits. Therefore, before you file an application for Social Security benefits, it is important to understand each step of the review process.

Specifically, step two is important because it is a threshold step. If you aren’t able to get past step two, then you have not met the threshold requirement of having a severe medical condition. As such, understanding step two of the review process will help you win your benefits.

The first step in the review process asks: are you working. If you are working full time then you cannot even apply for SSDI or SSI benefits. However, if you are not working, then the step two question is: Do you have a severe medical condition?

In this blog, we will explore the definition of step two of the disability review process. Additionally, we’ll provide tips to enhance your success in winning monthly SSDI and SSI payments.

THE SSA USES STEP TWO AS A THRESHOLD FOR SSD BENEFITS

When medical evidence establishes only a slight medical issue which has no more than a minimal effect on your ability to work, then your medical condition is “not severe.” For example, a broken arm is not severe because it will heal within a matter of months. Likewise, a problem like high blood pressure, that you can control with medication, is not a severe medical issue. Normally, you would not receive benefits for such minor medical problems.

Therefore, to proceed through the SSA review process, you must prove you have a severe physical or mental condition. If the SSA finds your condition is not severe, then they will deny your claim for benefits.

Some people have severe medical conditions but are still able to work. Usually, this is because treatment and medications control their medical condition. For example, if insulin controls your severe diabetes type 2, then your illness would not be severe. Millions of people have diabetes type 2 and they still are able to work. It is when their symptoms no longer respond to treatment that it impacts their ability to work.

STEP TWO: DO YOU HAVE A SEVERE MEDICAL CONDITION?

The SSA has a very specific definition of how they know a medical condition is severe under step two. Their definition is basic. It states that the symptoms of your medical condition must limit your ability to perform basic work activities.

Basic work activities require the ability to use physical and mental tasks. For example, if your medical condition impacts your ability to perform physical tasks, then it may impact your ability to walk, sit, stand, lift, push and carry. Likewise, if your medical condition impacts your mental health, then it may impact your ability to speak, hear and concentrate. You may also struggle to follow instructions and get along with other people. That could include getting along with the general public or other workers and your boss.

As you can see, sitting, for example, is a basic activity. Concentration is also a basic requirement of most jobs. Therefore, if your medical symptoms limit your ability to perform these basic tasks, then you pass the step two threshold. Your case will then move on to step three:  do you meet or equal a listing.

WHAT HAPPENS IF YOU DON’T HAVE MEDICAL EVIDENCE AT STEP TWO?

Step who is an assessment of the functional limitations that effect you. It is also an assessment of limits related to your symptoms and any other restrictions from your medical condition. If you have a medical condition that could reasonably produce your symptoms, then the SSA will find your medical condition has more than a minimal effect on your ability to do basic work activities.

Therefore, the SSA will find that your medical condition is severe and proceed to the next step in the review process. This is true even if the objective medical evidence would not in itself establish that your medical condition is severe. When you don’t have medical evidence or the evidence shows only a slight problem or a combination of slight problems which would have no more than a minimal effect on your ability to work, then you do not pass step two. This is the case, even if the SSA considers your age, education, or work experience.

Additionally, after considering all of the evidence, if the SSA is unable to determine clearly the effect of a medical condition on your ability to do basic work activities, then they must continue to follow the evaluation process until a determination can be made. SSR 96-3p. 

A good explanation of what should happen if the SSA cannot determine if you pass the step two threshold in Social Security’s rulings. As SSA guidelines state, great care should be taken in when applying the “not severe” concept. If the SSA is unable to clearly determine the effect of a medical condition or combination of conditions on the ability to do basic work activities, then the evaluation should not end at step two. Rather, it should continue. 

UNDERSTANDING THE DURATION TEST IN THE SSA REVIEW PROCESS

The duration test is a critical component of step two. It serves to ensure that only those with long term illness qualify for SSDI and SSI benefits. To pass this test, your medical condition must meet two key criteria:

• Expectation of Death: Your condition must not be expected to result in death. This means that the SSA is looking for conditions that are serious but not terminal. If your medical condition will result in your death, then it falls under different SSA criteria.
• Duration of the Condition: Your medical condition must have lasted, or be expected to last, for a continuous period of at least 12 months. This requirement is in place to filter out temporary conditions that do not impact your ability to work in the long run.

If your condition does not meet these criteria, then your claim may be denied at step two. It’s important to provide medical records that clearly outline the nature of your condition and how it affects your daily life and ability to work.

The SSA will deny your benefits if your medical condition fails the duration test. That is, if your medical condition (1) is not expected to result in death, and (2) has neither lasted 12 months nor is expected to last for a continuous period of 12 months, then you fail the test. The SSA uses the duration test at step 2. But the SSA can invoke the same test at step 3, 4, or 5. You can learn about all five steps of the SSA review process.

TIPS FOR MEETING THE DURATION TEST

How long your illness will last is one of the main facts that determines whether or not you will receive benefits. Short term medical conditions simply are not severe enough to keep you from working for over one year. Your condition must last at least one year for you to win benefits. Therefore, you need to know certain tips to help you meet step two:

• Go To the Doctor: You must have medical evidence to prove your medical condition.
• Gather Medical Evidence: Ensure you have all of the medical records from your treating providers. The medical evidence details the history and symptoms of your condition. This includes treatment plans, progress notes, and any test results.
• Document Symptoms: Keep a detailed log of your symptoms and how they affect your daily activities. This can illustrate your medical illness to the SSA.
• Consult with Specialists: Seek evaluations from experts who can provide insights into your medical condition. Their expert opinions can strengthen your case.
• Stay Informed: Understand the specific requirements of the SSA regarding the duration test. Familiarize yourself with the types of conditions that meet the test.

By meeting the duration test, you can enhance your chances of passing step two of the review process. Remember, the goal is to prove your condition is severe and impacts your ability to work.

MEDICAL EVIDENCE PROVES YOU MEET STEP TWO 

When you apply for SSDI and SSI benefits, the SSA will review your medical records to see if they can pay you benefits. Medical records are crucial to proving you meet step two. Find out about the importance of medical records in your SSD case.

The SSA obtains your medical records. Next, an SSA worker reviews your medical records. To pass step two of the review process, send the SSA records about your severe medical condition. For example, the SSA will want to see the following items:

• medical imaging, such as MRI, CT scan, or X-rays
• physical exam notes or progress notes from your doctor
• a record of your medications for pain and any side effects you may be experiencing from your medications
• the medical opinion of an expert, like a surgeon or a doctor that is an expert in your condition
• physical therapy records that show your attempts to help your pain
• mental health progress notes from your counselor

The SSA’s decision is based on medical opinions and exams from your doctor and the SSA’s doctors. Learn what to expect at the SSA doctor exam.

FIND A DOCTOR, EVEN IF YOU DON’T HAVE HEALTH INSURANCE

You cannot pass the step two threshold test if you don’t have a doctor. Therefore, you need to find one. You might now have a doctor because you don’t have health insurance. Or, you may think you can’t get a doctor, because you don’t have money to pay for treatment. However, there are options, even if you are broke. If you need medical treatment or mental health counseling and you cannot afford it, then review our lists of free resources in your state:

• CALIFORNIA FREE AND LOW COST CLINICS
• COLORADO FREE AND LOW COST CLINICS
• IDAHO FREE AND LOW COST CLINICS
• NEVADA FREE AND LOW COST HEALTH CLINICS
• UTAH FREE AND LOW COST HEALTH CLINICS

With these free resources you can get treatment from a counselor, nurse or doctor. They can also give you medication. Choose your state. Then, call the free clinic for medical treatment. The resources on our lists will help you get the medical care you need.  These resources will also help to build the medical record to win your SSD benefits. You can also apply for Medicaid benefits. If you qualify for it, then it should help pay for doctor visits and medication.

WHAT OUR LAW FIRM DOES FOR YOU

You do not have to meet the step two requirements on your own. Our law firm can help you prove that your case should move past step two. We can help file your SSD application. Also, we can help you through each of the appeal stages during the Social Security process.

When you leave that up to us, you can focus on your health. Our attorneys and staff can:

• Help you file your application for SSDI and SSI benefits
• File an appeal if you receive an initial denial from DDS
• Collect your medical records
• Help you confirm your SSA Doctor Exam
• Request a Hearing with an Administrative Law Judge
• Prepare you to testify at your ALJ hearing
• Represent you at your hearing
• Question the expert witnesses
• Read about the job expert at your SSA hearing
• Learn about medical expert testimony
• Request review of an SSA decision with the Appeals Council
• Request review of an Appeals Council denial in Federal Court

If you file your SSD application online at Social Security’s website, then you have 6 months to complete it. It is best to complete the application quickly. You don’t want to run out the 6 month time limit.

HOW TO PASS THE STEP TWO THRESHOLD TEST

At our law firm we prove your medical condition passes the step two test.  Remember, there are two types of benefits:  SSDI benefits and SSI benefits. When you file an application, you are filing for both types of Social Security benefits.  However, it doesn’t matter if you are filing an application for SSDI, SSI, or for both. You still must past the step two threshold test.

When you file your online application for benefits, the SSA will send you a written summary of your application. If you receive the written summary in the mail, then you need to sign it. Then, send it back to the SSA. The SSA gives you an envelope to send it back. Do it quickly. If you delay, then it delays the case.

Additionally, once you file your application for benefits, then send the SSA your medical records. You can get a copy of your records from your doctor. Or, you can download a copy of your records from your health insurance portal. By sending the SSA your medical records, you will prove that your condition passes the step two test. Finally, even if the SSA denies your case, never give up. You can always appeal.

As Social Security experts, our attorneys will properly present your case to the SSA. Contact us today. Take advantage of our free review of your case. We can often give you information that will help you pass the step two test and win benefits. We are experts in SSI and SSDI benefits. Call today. Put our legal experience to work for you.