So, a person isn't working, they are seeing a doctor regularly, and they have medical records that show they have some medical problems. At Step 3, Social Security looks at how severe those medical problems are. To do this Social Security maintains a listing of medical criteria that are considered to be so severe that a person will be found to be disabled if his or her medical condition matches them. This is probably best illustrated by way of a couple of examples:
John isn't working and he has a medical diagnosis of chronic kidney disease and he has reached the point that he has recently began dialysis treatments on a weekly basis. He applies for Social Security disability benefits and submits his medical records to Social Security for their review. The person reviewing John's medical records sees that he has chronic kidney disease and that John is now on dialysis. The reviewer looks up the relevant "listing" for John's condition. In this case it is Listing 6.03 Chronic kidney disease , with chronic hemodialysis or pertioneal dialysis. Because John's medical condition exactly meets the elements of the listing - his medical records indicate that he has chronic kidney disease and he is on dialysis - he is found to be disabled and is awarded his disability benefits.
Mary has a long history of chronic back pain from an old back injury. Over the years the pain has gotten worse and worse to the point she had to quit her job as a waitress. Her doctor has examined her and noted in her medical records that she demonstrated a "positive straight leg raise" - an indication that Mary may have a bulging disc in her back. Her doctor ordered an MRI for her lower back which showed she has moderate degenerative disc disease in her lower back and a bulging disc. The bulging disc, however, was not pressing against a nerve root in her spine. Mary applies for Social Security disability benefits and submits her medical records for review. The person reviewing Mary's records notes the history of chronic back pain and reviews the MRI report. The reviewer looks up the relevant "listing" for Mary's condition: Listing 1.04 Disorders of the spine. To be found disabled under this listing, the medical records have to show a disorder of the spine - such as Mary's bulging disc - resulting in compromise of a nerve root in her back. In Mary's case, because her bulging disc doesn't impact a nerve root, she does not meet the listing and she cannot be found disabled at this step under Listing 1.04. The evaluation of her claim will have to go on to next step in the process.
In the real world, medical problems don't always fall into neat categories. Social Security knows that and after reviewing a person's medical records, they may determine that even though a medical condition doesn't exactly meet the specific requirements of a particular listing, the symptoms are such that the condition is medically equivalent to one described in the listings. This is called "equaling a listing." If a person's medical condition is found to be equal in severity to a medical condition described in the listings, Social Security will find that that person is disabled.
Here are the take away points for Step 3:
- Meeting or equaling a listing at Step 3 is the first point in the 5-step evaluation process that a person can be found to be disabled and be awarded their disability benefits. In John's case, he "met" the relevant listing so Social Security awarded him his disability benefits and he didn't need to go on to Steps 4 and 5.
- In Mary's case, just because she didn't met a listing doesn't mean she will not get her disability benefits: it just means that she will have go on to complete Steps 4 and 5 before that determination can be made.