Step 1: Initial Application Review by SSA

The process begins with the SSA verifying non-medical eligibility criteria such as:

• Work credits: Have you worked long enough and recently enough to qualify?
• Income and resources: Are you engaging in Substantial Gainful Activity (SGA)? If you're earning more than a certain monthly limit, your claim may be denied at this stage.
• Basic documentation: Does your application include all required forms and identification?

If you meet these criteria, your claim is forwarded to Washington State’s Disability Determination Services.

Step 2: Medical Evaluation by Washington DDS

The Washington DDS is a state agency that reviews the medical portion of your claim. Here's what they assess:

• Medical records: They examine your medical history, doctor’s notes, lab results, hospital visits, prescriptions, and treatment plans.
• Functional limitations: They determine how your medical condition limits your ability to perform basic work activities such as sitting, standing, lifting, concentrating, or interacting with others.
• Consistency of evidence: DDS looks for consistent documentation across your treatment history that supports your reported symptoms and limitations.

In some cases, DDS may order a Consultative Exam (CE) with an independent physician if they need more information.

Step 3: Five-Step Sequential Evaluation Process

Washington follows the same five-step process used nationwide to determine disability:

1. Are you working?
   If you're earning more than the SGA threshold, your claim will likely be denied.
2. Is your condition “severe”?
   Your condition must significantly limit your ability to do basic activities for at least 12 months.
3. Is your condition on the SSA’s list of impairments?
   If it matches a condition on the SSA’s official Listing of Impairments, you may be approved more quickly.
4. Can you perform your past work?
   DDS will evaluate whether you can still do any of the jobs you’ve held in the last 15 years.
5. Can you do any other work?
   If you can’t return to past work, DDS assesses if you can do other types of work based on your age, education, and skills.

Step 4: Decision Issued

After all evaluations are complete, Washington DDS will send its recommendation back to the SSA, which then makes the official decision. You’ll receive a letter in the mail either approving or denying your claim, along with an explanation.

If denied, you have the right to appeal—and it’s important to act quickly, as deadlines apply.