Ed: Okay, so the basic definition – the way social security goes about determining eligibility for disability benefits… The first thing they ask is if an individual is working. If an individual is working and making a certain amount of money (this year, that is $1,310 or more per month) (and that is gross, not net, before taxes) you are disqualified from benefits regardless of your medical condition. That pertains to disability insurance benefits. You have to show that the individual claiming benefits has the medical impairment that has lasted, or is expected to last, 12 months or more resolved in an early death, and causes more than a minimal impact on the ability to engage in work activities.
In other words, if you get a hangnail, sprained thumb, or bump on the foot, that is probably not going to meet the durational or severity requirements. Social security has developed what they call their listings of impairments. A colleague of mine used to describe the listings as a cook book, it’s got certain criteria, or ingredients, and if you have one of those listed conditions, and you have all of the ingredients, you’ll meet the other criteria, social security will find that you are disabled and entitled to benefits. A brief example, if you have, say a bulging disk in your back, and we can show on x-ray that the disk is impinging a nerve, and because of that you have experienced muscle atrophy in one of your legs, with reflex loss and loss of strength, then you will be entitled to benefits. You will have met the criteria in the listings. If you don’t meet the criteria in the listings, that doesn’t mean you lose. That means we keep moving.
At this point, the social security administration tries to determine the individual’s residual functional capacity, and what that means is “what can the person still do despite the limitations of their impairments?”. Once the residual functional capacity is determined, then social security will match that up against the requirements of the work the individual has been doing. And if the individual can show that, because of their residual functional capacity, they cannot perform the work they were doing before, then we move to the next step… If that residual functional capacity would allow for the performance of past work, then the inquiry is stopped and the individual is found to not be disabled. So, let’s move on, we get the residual functional capacity – the persons restricted to lifting 10lbs occasionally and cannot be on their feet for more than a couple of hours out of an 8 hour day, and the work they were performing was heavy construction work – so obviously these limitations keeps them from being able to do their construction work – does that mean they’re entitled to disability benefits? Not yet! We now have to find if that person is not capable of performing any other work that exists in significant numbers in the national economy.
If an individual can do sedentary work, they are not going to be disabled. However, one of the few things social security has done right in their disability determination process is that they realize that as we grow older, our ability to adapt to different types of work situations decreases. We cannot teach an old dog new tricks. So, the rules change once an individual reaches 50, and then again once an individual reaches age 55. As we get older, it becomes easier to meet the standard of finding a disability.