Determining Disability
I CAN'T WORK!
Applying for Social Security Disabilityor Supplemental Security Income
- The ultimate question in all social security disability (SSD) and supplemental security income (SSI) cases is why the claimant can’t work. Both programs are governed by a complicated collection of regulations, rulings and case law decisions.
- An applicant must have physical and mental limitations that affect work functions that are medically determinable. Work is defined as 8 hours per day, 5 days per week and is referred to as substantial gainful work activity (SGA). Part time work or sheltered work is not SGA.
Generally, the focus for disability requires having significant functional limitations that are characterized as being markedly impaired limitations (that is something more than mild or moderate). The focus for evaluating markedly impaired functions is whether the impairment affects age appropriate cognitive and communications functions, social functions, personal functions or whether there are difficulties in maintaining concentration, persistence, or pace.
- Common examples of physical work functions are the ability to sit, stand, walk and lift. Common mental (non-exertional) work functions are the ability to concentrate, persist, maintain pace, follow simple one and two step instructions or engage in work with minimal contact with co-workers, supervisors or the general public.
- Chances of success increase with a person's age starting at age 50. Continuous re-filing is usually less successful than appealing an initial denial at least twice up through the Administrative Law Judge hearing level.
Excerpted from SSA Publication No. 05-10029, May 2008
How does Social Security decide if you are disabled?
Social Security uses a five-step process to decide if you are disabled.
1. Are you working?
If you are working and your earnings average more than a certain amount each month, Social Security generally will not consider you disabled. The amount changes each year, and is $940 for 2008. If you are not working, or your monthly earnings average the current amount or less, the state agency then looks at your medical condition.
2. Is your medical condition "severe"?
For the state agency to decide that you are disabled, your medical condition must significantly limit your ability to do basic work activities-such as walking, sitting and remembering-for at least one year. If your medical condition is not that severe, the state agency will not consider you disabled. If your condition is that severe, the state agency goes on to step three.
3. Is your medical condition on the List of Impairments?
The state agency has a List of Impairments that describes medical conditions that are considered so severe that they automatically mean that you are disabled as defined by law. If your condition (or combination of medical conditions) is not on this list, the state agency looks to see if your condition is as severe as a condition that is on the list. If the severity of your medical condition meets or equals that of a listed impairment, the state agency will decide that you are disabled. If it does not, the state agency goes on to step four.
4. Can you do the work you did before?
At this step, the state agency decides if your medical condition prevents you from being able to do the work you did before. If it does not, the state agency will decide that you are not disabled. If it does, the state agency goes on to step five.
5. Can you do any other type of work?
If you cannot do the work you did in the past, the state agency looks to see if you would be able to do other work. It evaluates your medical condition, your age, education, past work experience and any skills you may have that could be used to do other work. If you cannot do other work, the state agency will decide that you are disabled. If you can do other work, the state agency will decide that you are not disabled.
Even a brief review of the disability determination process excerpted above reveals how complicated Social Security's regulations can be. Since 1980, Gary J. Pandora & Darin G. Kendall has been helping people obtain the disability and SSI benefits that are so important to their future.