|The 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.
SSA considers an individual disabled if, due to an established medical condition, he or she: – meets or equals one of our medical Listings (criteria that are presumed to preclude work for most people); – can not perform any of his/her work that was done before; or – cannot make an adjustment to other work.
Step 1: Is the individual working above SGA level ? At the first step, we consider an individual’s work activity, if any. SGA stands for Substantial Gainful Activity and the amount changes each year. For 2009 it is $980 for the non-blind and $1640 for the blind. z If an individual is working and his or her earnings average more than the SGA limit a month, then he or she is found not disabled. z If an individual is not working or his or her earnings are less than SGA, the adjudicator goes to step two.
Step 2: Is the individual’s physical and/or mental condition severe? At the second step, we consider the medical severity of an individual’s impairment(s). z An individual must have a medically determinable physical or mental impairment (or a combination of impairments) that is severe and meets the duration requirement. z To be severe an impairment or impairments must interfere with basic work-related activities. z To meet the duration requirement the impairment(s) must be expected to last twelve months or to result in death z If the impairment(s) are not severe or do not meet the duration requirement, the individual is found not disabled. z If the impairment(s) are severe and meet the duration requirement, the adjudicator goes to question three. Basic Work-Related Activities z Physical: – lifting, carrying, standing, walking, sitting, pushing, pulling, plus the “nonexertional” activities rated in the Selected Characteristics Of Occupations Defined in the Revised Dictionary of Occupational Titles (SCO). z Mental: – Ability to understand, carry out, and remember simple instructions – Make simple, work-related judgments and decisions – Respond appropriately to supervision, coworkers and work situations – Deal with changes in a routine work setting
Step 3: Does the individual’s medical condition meet or equal the severity of a Listing? z At the third step, we also consider the medical severity of an individual’s impairment(s). z SSA maintains a listing of medical criteria that are considered to be so severe that an individual is found to be disabled if his or her medically determinable physical or mental impairment(s) matches them. z An individual’s impairment(s) can be found to meet the listed criteria exactly or to be of equal severity. z If an individual has an impairment that meets or equals one of the listings and meets the duration requirement, he or she is found to be disabled. z If an individual does not have an impairment that meets or equals one of the listings or the duration requirement is not met, the adjudicator goes to
Step 4. z However, before going from step three to step four, the individual’s residual functional capacity (RFC) is assessed. This RFC assessment is then used at both step four and step five. What is Residual Functional Capacity or RFC? z Ordinarily, RFC is a function-by-function assessment of an individual's maximum ability to do sustained work-related physical and mental activities on a regular and continuing basis (8 hours a day, for 5 days a week) despite the limitations and restrictions resulting from his or her medically determinable impairments. z In short, it is an accounting of an individual’s capacity for full-time work. Limitation vs. Restriction z Limitations: Define activity levels beyond which an individual is physically unable to perform on a sustained basis. z Restrictions: Define activity levels beyond which it would be medically ill-advised for an individual to perform on a sustained basis.
Residual Functional Capacity (RFC) z For the physical RFC (PRFC) an individual’s medical condition is evaluated in terms of the physical demands of work used in the Dictionary of Occupational Titles (DOT) and SCO. z Mental RFC (MRFC) is evaluated in terms of the mental demands of work set out in the Code of Federal Regulations (CFR). z The sole purpose of assessing RFC is to determine an individual’s ability to work at steps 4 and 5.