To get approved for disability, you must prove that you cannot work
On this site, we speak many times about the various aspects of the disability process, including both medical and vocational factors such as past work, medical records, the medical vocational allowance, and the social security definition of disability.
Another factor of the Social Security Disability and SSI disability process, however, is a concept known as other work. What is "other work" and how does it play into the disability process? Basically, this way---when you apply for disability (either SSD or SSI), your case has to pass several tests.
Severe vs non-severe impairments
The first is that you must have a severe impairment. What is a severe impairment in the eyes of the social security administration? The actual concept of a "severe impairment" is somewhat subjective; however, most individuals who process disability claims would agree that a sprained wrist or sprained ankle would not qualify as a severe impairment, whereas a ruptured disc or a broken limb would.
Can you be denied for disability if your condition is judged to be non-severe? Yes, however, denials issued for an NSI (non-severe impairment) are infrequent, simply because most individuals do not file for disability on the basis of minor medical issues.
Having a severe impairment is the first test to pass. If a claimant's condition is judged to be severe, then the next test involves "duration". For the social security administration, this means that a severe impairment must last for at least 12 months. Does this mean that you must be disabled for 12 months before you can apply? No, social security can evaluate your medical records and make a determination as to whether or not your condition will be expected to last 12 months or longer.
A claimant must have a severe impairment and this impairment must last, or be expected to last for, 12 months or longer. But what makes it disabling? In other words, what makes a person qualify for disability. Answer:the inability to perform work.
Understanding the definition of disability
A person who qualifies for disability will have a severe impairment, lasting not less than a year that A) prevents from working at one of their former jobs and B) prevents them from working at some type of other work.
Many people who explain the disability process tend to stop at this point, because it can get a little confusing. Here's why---the social security definition of disability does not imply that a claimant cannot work. It actually means that, to be considered disabled, a claimant cannot have the ability to work and earn more than a certain threshold of income. That threshold is known as SGA, or substantial gainful activity.
So, let's recap. Qualifying for disability means that your impairment must be severe, must last a year or longer, and must prevent you from being able to engage in your past work or some form of other work activity while earning more than a certain minimum monthly amount (sga, mentioned in the prior paragraph).
Now, what is "other work"? Well, first let's define past work. Past work may potentially include any job that you did in the last 15 years (known as "the relevant period"). Other work is potentially any kind of work that you might possibly be able to do anywhere in the national economy, i.e. anywhere in the country.
"Other work" is the step in the process by which many applicants for disability get denied. Why? Because it is often fairly easy to conclude that a claimant is incapable, based on their functional limitations, to go back to their past work. However, it is sometimes even easier to assert that while a claimant cannot do their past work, they can neverthless perform some type of other work (even if those jobs don't exist in your immediate area).
Fortunately, there is a mechanism in the disability process that adds some fairness into the equation. And that mechanism is the grid, a system of vocational rules that affect what types of other work a claimant can be considered capable of doing. These vocational rules take into account a person's age, the types of job skills they have developed over the course of their work history, the specific physical or mental limitations that they possess as a result of their condition, and even (to a small degree) their education level.
Getting a claimant approved on the basis of these rules means getting them a medical vocational allowance. And this means more than simply referring to a claimant's medical evidence. It means having familiarity with the vocational grid rules used by SSA, it means having a knowledge of basic limitiations (for example, the inability to crouch, stoop, maintain balance, concentrate, remember, etc, etc) and how those limitations affect one's work ability, and it also means knowing how point out to an administrative law judge (at a disability hearing) how a claimant's vocational profile and functional limitations make it impossible to engage in past work or other work.
Obviously, "other work" is a step in the disability process where many individuals get denied. However, with proper preparation before a hearing (typically, this means having a competent attorney who specializes in Social Security Disability and SSI cases), a successful argument can be made that a claimant is incapable of performing other work, resulting in an approval of disability benefits.
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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