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Overview of the Disability Process

Overview of the Disability Process. Definition of Disability.

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Overview of the Disability Process

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  1. Overview of the Disability Process

  2. Definition of Disability • 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. Social Security Act, §§ 223(d)/1614(a)(3)

  3. And. . . An individual shall be [disabled] only if his physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy. . . .

  4. Sequential Evaluation ProcessAdults 1. SGA? NO  Go to 2. YES Not disabled 2. Severe? YES  Go to 3. NO Not disabled 3. Meets/equals listing? YES Disabled NO    RFC Assessment 4. PRW? NO  Go to 5. YES Not disabled 5. Other work? YES  Not disabled NO Disabled

  5. Step 1—SGA? “Inability to engage in any substantial gainful activity. . .” • Nonblind level: $940/month – 2008 • Blind level: $1,570/month – 2008

  6. “Severe”? • Slight abnormality or combination of slight abnormalities • More than minimal impact on basic work activities, e.g.-- • walk, stand, sit, lift, carry • see, hear, speak • understand instructions, get along with coworkers

  7. Step 3: Meet or equal? “. . . only if his physical or mental impairment is of such severity . . . .” • “Listing of Impairments” (the listings) • “Meets” • “Medically equals”

  8. The Listings • Part A — Age 18+, some <18 Part B — < Age 18 only • “Body Systems” Musculoskeletal Special Senses and Speech Respiratory Cardiovascular Digestive Genitourinary Hematological Skin Endocrine Multiple Body Neurological Mental Malignant Neoplastic Immune Growth (Part B only)

  9. Residual FunctionalCapacity (RFC) • For steps 4 and 5 • Physical and mental abilities • e.g., sit, stand, walk, push, pull; vision, environment; understand, remember, carry out instructions, respond to supervision, get along with coworkers/others • 8 hrs/day, 5 days/wk

  10. Step 4: Past Relevant Work? “. . . is not only unable to do his previous work . . . .” • 15 years • SGA • As performed and “as generally performed”

  11. Step 5: Other Work? “. . . but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy. . . .”

  12. Other Work RFC, age, education, work experience Medical/Vocational Guidelines (“Grids”)

  13. Monte Hetland, M.D Pediatric Medical Officer Office of Disability Programs

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