GLOSSARY OF SOCIAL SECURITY TERMS RELATED TO DISABILITY
Administrative law judge (ALJ)—
Administrative law judges in the Office of Hearings and Appeals of the Social Security Administration conduct hearings and make decisions on cases that are appealed by individuals whose claims have been denied by state agencies.
Administrative review process—
The procedures followed in determining eligibility for, and entitlement to, benefits. The administrative review process consists of several steps, which usually must be requested within certain periods and in the specified order.
The percentage of claims allowed in a given time period. At the hearing level, allowance rates are computed either as a percentage of dispositions (including dismissals) or as a percentage of decisions (excluding dismissals).
The organization within the Office of Hearings and Appeals of the Social Security Administration that makes the final decision in the administrative review process. When an individual disagrees with the decision or dismissal of the ALJ, he or she may, within 60 days of receiving the hearing decision, request that the Appeals Council review the decision. The Appeals Council may deny or dismiss the request for review, or it may grant the request and
either issue a decision or remand (return) the case to an ALJ. The Appeals Council may also review any ALJ action on its own motion within 60 days after the ALJ’s action.
An action adding an individual to the Social Security benefit rolls.
An individual on the Social Security benefit rolls.
An individual who has applied for benefits and whose claim is still pending.
A claim for both Title II (Old Age Surveys and Disability Insurance) and Title XVI (Supplemental Secuity Income) benefits.
Continuing disability review—
An evaluation of a disabled beneficiary’s impairments to determine if the person is still disabled within the meaning of the law.
The simultaneous cessation of payment of a specific type of benefit and entitlement of the beneficiary to another type of benefit. Title II disabled worker beneficiaries are converted to retirement benefits when they attain normal retirement age.
Disability Insurance under Title II of the Social Security Act.
For purposes of Title II (Old Age Surveys and Disability Insurance) benefits and Title XVI (Supplemental Security Income) benefits for adults, disability is the inability to engage in any substantial gainful activity by reason of any medically determinable impairment that can be expected to result in death 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, considering age, education, and work experience, engage in any other kind of substantial gainful work that exists in the national economy. 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. For SSI disabled child benefits, a child under age 18 is considered disabled if he or she has any
medically determinable physical or mental impairment(s) that result(s) in marked and severe functional limitations and that can be expected to last for a continuous period of not less than 12 months.
Disability Determination Services (DDS)—
The state agency that makes the initial and reconsideration determination of whether a claimant is disabled or a beneficiary continues to be disabled within the meaning of the law.
An employee of a state’s Disability Determination Services who collects medical evidence and, usually in conjunction with a physician, makes a determination on a claimant’s disability.
A factor in the determination of disability. To be eligible for benefits, a claimant must have a disability that has lasted, or is expected to last, 12 months or to end in death. See Sequential evaluation process.
A step in the sequential evaluation process. Regulations issued by the Social Security Administration include a Listing of Impairments, which describes, for each major body system, impairments that are considered severe enough to prevent a person from doing any substantial gainful activity. A determination that an impairment is equal in severity to the criteria in the listings is sufficient to establish that an individual who is not working is disabled within the meaning of the law. See Sequential evaluation process.
The level following reconsideration in the administrative review process. The hearing is a de novo procedure at which the claimant and/or the claimant’s representative may appear in person, submit new evidence, examine the evidence used in making the determination under review, give testimony, and present and question witnesses. The hearing is on the record but is informal and nonadversarial.
One of the 138 locations of the Office of Hearings and Appeals of the Social Security Administration at which hearings are held.
Medical expert (ME)—
A physician or mental health professional who provides impartial expert opinion at the hearing level of the disability claims process. MEs either testify at hearings or provide written responses to interrogatories.
A common term for the Listing of Impairments issued by the Social Security Administration as part of the regulations on determining disability. The listings describe, for each major body system, impairments that are considered severe enough to prevent a person from doing any substantial gainful activity. An impairment that meets or equals the criteria in the listings is sufficient to establish that an individual who is not working is disabled within the meaning of the law.
A step in the sequential evaluation process. Regulations issued by the Social Security Administration include a Listing of Impairments, which describes, for each major body system, impairments that are considered severe enough to prevent a person from doing any substantial gainful activity. An impairment that meets the criteria in the listings is sufficient to establish that an individual who is not working is disabled within the meaning of the law. See Sequential evaluation process.
An impairment that does not significantly limit a person’s physical or mental ability to perform basic work activities. See Sequential evaluation process.
Work that exists in the national economy, other than the work a person has done previously. See Sequential evaluation process.
An independent reexamination by state agencies of all evidence on record related to a case. It is based on the evidence submitted for the initial determination plus any further evidence and information that the claimant or the claimant’s representative may submit in connection with the reconsideration. A reconsideration determination is made by a different disability examiner and physician/psychologist from the ones who made the original determination.
Sequential evaluation process—
The five-step process used in determining whether an individual meets the definition of disability in the law. A determination at any step that an individual is disabled or not disabled ends the process.
Supplemental Security Income (SSI)—
Supplemental Security Income, Title XVI of the Social Security Act, a program that provides benefits to low-income aged, blind, and disabled individuals who meet income and resource requirements.
Substantial gainful activity (SGA)—
Remunerative work that is substantial, as determined from consideration of the amount of money earned, the number of hours worked, and the nature of the work. The dollar amount is established by regulations.
The ending of entitlement to a type of benefit. Disabled workers’ benefits are most commonly terminated because of death, conversion to a retirement benefit at age 65, or recovery from their disabling condition.
A claimant’s past relevant work. See Sequential evaluation process.
Age, education, and work experience, considered at the final step of the sequential evaluation process.
Vocational expert (VE)—
Professional who provides factual information and expert opinion relevant to particular vocational questions, which may be raised at the hearing level of the disability claims process.
Source: List of SSA terms related to Disability Insurance taken from glossaries in Social Security Advisory Board (2001a, 2001b).