When you’re struggling with a serious medical condition that makes it nearly impossible to hold down a job, being told by the Social Security Administration (SSA) that you’re “not disabled enough” can feel like a cruel joke. However, the reality is that the SSA doesn’t just look at your diagnosis – they evaluate whether your impairments prevent you from engaging in substantial gainful activity (SGA), as defined under 20 CFR § 404.1572. Understanding how this determination is made is key to building a successful claim for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

The SSA’s Five-Step Disability Evaluation Process

The SSA uses a rigorous five-step evaluation process to determine whether you are disabled. This process is described in 20 CFR § 404.1520. Here is how it works:

• Are you working? If your income exceeds the SGA threshold (currently $1,550 per month in 2024 for non-blind individuals), you may not be considered disabled under Social Security disability benefits.
• How severe is your condition? Your impairment must significantly limit your ability to perform essential work activities, such as walking, sitting, remembering, or concentrating, for at least 12 months.
• Do you meet a specific listing in the SSA’s Blue Book? The Social Security Administration maintains a list of conditions that automatically qualify for disability benefits (20 CFR Part 404, Subpart P, Appendix 1). If your condition meets or equals one of these listings, you will likely be approved for benefits.
• Have you been able to do your previous work? The Social Security Administration will review your work history over the past 15 years. If the Residual Functional Capacity assessment (RFC), which assesses what you can still do despite your limitations, shows that you could return to any of these jobs, your claim may be denied.
• Can you adapt to other work? Even if you cannot perform your previous job, the Social Security Administration (SSA) considers your age, education, work experience, and functional capacity (RFC) to determine whether you could perform another job in the national economy. This is where many claims fall short – and where legal assistance becomes crucial.

Why “Not Disabled Enough” Is Often a Misreading of Your Limitations

Many denials hinge on steps 4 and 5. The Social Security Administration may acknowledge your condition, but they may still conclude that you are able to perform sedentary work or that your skills can be transferred to another role. However, these conclusions often ignore real-world limitations.

For example, someone with chronic pain may technically be able to sit for six hours, but they may need frequent breaks, position changes, or even days off due to flare-ups. Similarly, a person with anxiety may find it difficult to concentrate, making even simple tasks seem overwhelming in a structured workplace. These factors don’t always appear in the paperwork alone, as they require a more nuanced understanding of the individual’s needs and circumstances.

That’s why a comprehensive assessment of your RFC, supported by medical records, doctor’s statements and, in some cases, expert testimony, is essential. Under the Social Security Regulations (SSR) 96-8p, the Social Security Administration (SSA) must take into account all your limitations, both physical and mental, when determining your RFC.

The Role of Medical Evidence and Treating Physicians

The SSA considers the opinions of the treating physician if they are well supported and consistent with the medical records in accordance with 20 CFR § 404.1527 (c) (2). However, many applicants do not provide a detailed statement from their doctor explaining why they can’t work.

A strong medical statement should include:

• Specific functional limitations, such as “can stand for no more than 20 minutes at a time”
• How symptoms affect concentration, persistence, or pace
• Frequency of good vs bad days
• Need for unscheduled breaks or absences

If this information is not included, the Social Security Administration may rely on their own assessment, which often lacks depth and context.

How Tabak Law Fights for You

At Tabak Law, we believe that every case has a real person behind it facing a difficult situation. This could be due to disability, injury, or any other life-altering challenge. Our goal is to help our clients move from hardship to hope by providing them with compassionate, honest, and professional legal assistance.

If you have been denied SSDI or SSI benefits because the Social Security Administration (SSA) believes you are still able to work, don’t lose hope. While the system can be complex, you don’t have to go through it alone.

Contact Tabak Law for a free consultation to discuss your case. We can help you prove that your disability is genuine and that you deserve the benefits you have earned.