Review of Criteria and Qualifications for Social Security Disability Insurance
Definition of Disability
Specific criteria must be met to qualify for Social Security Disability Insurance (SSDI). The Congress of the United States has defined disability, for purposes of entitlement to disabled worker's benefits as the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.
A person must not only be unable to do his or her previous work but cannot engage in any other kind of substantial gainful work which exists in the national economy, considering the persons:
- work experience
It is immaterial whether such work exists in the immediate area, or whether a specific job vacancy exists, or whether the worker would be hired if he or she applied for work.
"The worker's impairment or impairment's must be the primary reason for his or her inability to engage in substantial gainful activity, although age, education, and work experience are also taken into consideration in determining the worker's ability to do work other than previous work".
5 Step Process to Determine Disability
1--Are you working? If you are and your earnings average more than $860 a month, you generally cannot be considered disabled. Note: This amount increases annually. See: What Is Substantial Gainful Activity (SGA)?
2--Is your condition severe? Your impairments must interfere with basic work-related activities for your claim to be considered.
3--Is your condition found in the list of disabling impairments? Social Security maintains a list of impairments for each major body system which are so severe they automatically mean you are disabled. If your condition is not on the list, Social Security must decide if it is of equal severity to an impairment on the list, and if so, the claim is approved.
4--Can you do the work you did previously? If your condition is severe but not of same or equal severity with an impairment on the list, Social Security determines if it interferes with your ability to do the work you did in the last 15 years. If it does not, your claim is denied. If it does, further consideration is given.
5--Can you do any other type of work? If you cannot do the type of work you did in the last 15 years, Social Security determines if you can do any other type of work with consideration given to age, education, past work experience, and transferable skills. If you cannot do any other type of work, your claim is approved. If you can, your claim is denied.
What Is Residual Functional Capacity?
Residual Functional Capacity (RFC) is the total of what one is left capable of doing after impairments have taken their toll. Social Security identifies the level of work capability in categories of:
- sedentary work
- light work
- medium work
- heavy work
Sedentary work is defined as "involving lifting no more than 10 pounds at a time and occasionally lifting and carrying articles like, docket files, ledgers, and small tools". Although sitting is primarily involved in a sedentary job, walking and standing should be required only occasionally. Standing and walking should total no more than 2 hours per 8 hour workday, while sitting would total about 6 hours per 8 hour workday. Most unskilled sedentary jobs demand good manual dexterity for repetitive hand and finger motions.
Light work is defined as "lifting no more than 20 pounds at one time with frequent lifting or carrying of objects weighing up to 10 pounds". A good amount of standing and walking, approximately 6 hours of an 8 hour workday, is usually required of jobs in this category. Good use of hands and arms for grasping and holding is important also. A seated position which involved extensive pushing and pulling of hand or foot controls would be included in the light work category too.
- In the age group 18-44, the maximum residual functional capacity allowed is "less than sedentary".
- For literate people of all education levels between age 45-49, the maximum RFC allowed is also "less than sedentary".
- Above age 50, with consideration given to education, and previous work experience, the maximum RFC increases to sedentary, light, or medium.