In this US Court of Appeals decision, the judges outlined the five-step process for assessing a claim for disability insurance benefits is spelled out in 20 C.F.R. § 404.1520(a)(4)(i)-(v).
At steps one and two, the Administrative Law Judge (ALJ) determines whether the claimant (1) is currently gainfully employed and (2) has a severe impairment, i.e., an impairment that significantly limits the claimant’s physical or mental ability to perform basic work activities. The claimant bears the burden of proof with respect to those initial steps. If the claimant is employed or does not have a severe impairment, he is not disabled and the analysis ends.
When the analysis proceeds to step three, the ALJ decides whether the claimant has an impairment that meets or equals an impairment listed in the regulations for being severe enough to preclude a person from doing any gainful activity. The step three “burden remains on the claimant, and he can establish his disability if he shows that his impairments match a listed impairment.”
If the claimant fails at step three, the ALJ must then determine the claimant’s residual functional capacity (“RFC”), which has been defined as “the most you can still do despite your [physical and mental] limitations.”
After determining the claimant’s RFC, the ALJ proceeds to step four, “where the burden rests with the claimant to show that he is not able to perform his past work.”
If the claimant succeeds at step four, the ALJ finishes at step five, where the burden shifts to the Commissioner. In order to withhold disability insurance benefits, the Commissioner must prove, “by a preponderance of the evidence, that the claimant can perform other work that exists in significant numbers in the national economy, considering the claimant’s [RFC], age, education, and work experience.” Id. (internal quotation marks omitted). If the Commissioner satisfies that burden, the claimant is not disabled and his claim for benefits must be denied.