The U.S. Census Bureau has reported that 56.7 million Americans had a disability in 2010, a figure that represents 18.7 percent of the civilian noninstitutionalized population included in the 2010 Survey of Income and Program Participation (SIPP) (Brault, 2012). Compared with 79.1 percent of working-age individuals (ages 18 to 64) without a disability that reported employment in the SIPP, only 41.1 percent of working-age individuals with a disability reported employment, a percentage that may be lower for individuals with impairments who could benefit from the use of products and technologies in the categories discussed in this report (Brault, 2012; Johnson et al., 2007; Kaye et al., 2000). Similarly, the 2014 American Community Survey found that more than half of the U.S. population with disabilities (51.6 percent) were people aged 18 to 64, while 40.7 percent were aged 65 and older. Of those aged 18 to 64 living in the community, 34.4 percent were employed, compared with 75.4 percent of this age group without disabilities (Kraus, 2015).
Social Security Administration
The U.S. Social Security Administration (SSA) provides monetary benefits to eligible individuals with disabilities through two programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). The SSDI program, established in 1956, provides benefits to eligible adults with disabilities who have paid into the Disability Insurance Trust
Fund and to their spouses and adult children who are unable to work because of severe long-term disability. Enacted in 1972, SSI is a means-tested program based on income and financial assets that provides income assistance from U.S. Treasury general funds to eligible adults aged 65 and older, individuals who are blind, and disabled adults and children. As of December 2015, approximately 11 million individuals were SSDI beneficiaries, and about 8 million were SSI beneficiaries (SSA, 2016b).
To receive SSDI or SSI benefits, an individual must meet the definition of disability: “if he or she has a medically determinable physical or mental impairment (or combination of impairments) that prevents him or her from doing any substantial gainful activity (SGA), and has lasted or is expected to last for a continuous period of at least 12 months, or is expected to result in death” (SSA, 2012a). In determining whether the definition of disability is met, SSA uses a five-step sequential process for adults.
- In the first step, SSA field offices perform financial screens to deny claims for applicants who work and earn income above the SGA limit (Wixon and Strand, 2013). SGA is defined as “work that involves doing significant and productive physical or mental duties and is done (or intended) for pay or profit.”1 The monthly SGA amount for nonblind individuals in 2017 is $1,170 after deducting impairment-related work expenses (SSA, 2017). Impairment-related work expenses, such as certain attendant care services, medical devices, equipment, and prostheses, may be deducted from any SGA (SSA, 2015). For SSDI applicants, insured status is verified, while countable income and resources are verified to be below thresholds for SSI applicants.
- In step 2, applicants receive medical screens to determine whether they have a medically determinable severe impairment. According to SSA’s Program Operations Manual System, “when medical evidence establishes only a slight abnormality or a combination of slight abnormalities which would have no more than a minimum effect on an individual’s ability to work, such impairment(s) will be found ‘not severe,’ and a determination of ‘not disabled’ will be made” (SSA, 2012b). Applicants will also be denied in step 2 if their impairment is “not expected to result in death, and has neither lasted 12 months nor is expected to last for a continuous period of 12 months” (SSA, 2012a).
- In step 3, an applicant’s impairment is assessed using the Listing of Impairments, which is a regulatory list of medical conditions and criteria created by SSA to assist in disability determination. If an
1 20 CFR § 404.1510.
applicant’s impairment “meets” or “equals” a listing and meets the duration requirement, the applicant is allowed benefits. To “meet” a listing, a claimant must have a medically determinable impairment that satisfies all of the criteria in that listing. An impairment “equals” a listing if it is “at least equal in severity and duration to the criteria of any listed impairment” (SSA, 2016c). SSA assesses an applicant’s residual functional capacity (RFC) when his or her impairment is severe but does not meet or equal the medical criteria within the Listings. SSA defines RFC as “an individual’s maximum capacity for performance taking into account the limitations resulting from his or her impairment” (SSA, 2016a).
- In step 4, SSA assesses whether an applicant’s RFC allows him or her to perform past work. An applicant who is able to perform past work will be denied benefits, but applicants who are unable to do so proceed to step 5.
- At step 5, an applicant’s RFC and vocational factors such as age, education, and work experience and transferrable skills are considered in determining whether he or she can perform other work in the national economy. Applicants who are determined to be unable to perform work in the national economy are allowed benefits, while those who are determined to be able to perform work are denied.
Americans with Disabilities Act
The Americans with Disabilities Act (ADA) helps individuals with disabilities in ways that differ from those of SSA. The ADA seeks to eliminate discrimination against any individual who is considered a “qualified individual with a disability.” The act defines disabilities through a three-pronged approach, in which each prong is its own definition. The first prong, often referred to as the “actual disability” prong, requires having a physical or mental impairment that substantially limits one or more major life activities to be considered a person with a disability2:
- Physical impairment is defined as “any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more body systems, such as neurological, musculoskeletal, special sense organs, respiratory (including speech organs), cardiovascular, reproductive, digestive, genitourinary, immune, circulatory, hemic, lymphatic, skin, and endocrine.”3
2 29 CFR § 1630.2(g).
3 29 CFR § 1630.2(h)(1).
- Mental impairment is defined as “any mental or psychological disorder, such as an intellectual disability, organic brain syndrome, emotional or mental illness, and specific learning disabilities.”4
- Major life activities is broadly defined to include, but is not limited to, the following list: “caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, sitting, reaching, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, interacting with others, and working.”5 The following are also included in the regulations as major life activities: “the operation of a major bodily function, including functions of the immune system, special sense organs and skin; normal cell growth; and digestive, genitourinary, bowel, bladder, neurological, brain, respiratory, circulatory, cardiovascular, endocrine, hemic, lymphatic, musculoskeletal, and reproductive functions. The operation of a major bodily function includes the operation of an individual organ within a body system.”6 A person need only be substantially limited in one major life activity to have a substantially limiting impairment.7
The second prong, often referred to as the “record of” prong, requires that an individual have “a record of a physical or mental impairment that substantially limited a major life activity.”8 This applies to an individual who had a substantially limiting impairment in the past or was misclassified as having one in the past, but does not currently have a substantially limiting impairment.
The third prong, often referred to as the “regarded as” prong, applies to individuals whom others regard as having a substantially limiting impairment.9 People often treat others differently if they regard them as having a substantial impairment.
The ADA mandates that “absent undue hardship,” employers must make reasonable accommodations for employees who meet the “actual disability” or “record of” prong definition of disability if the employees request them.10 Failure to do so is considered discrimination. The ADA protects individuals from discrimination in employment only if they are “qualified individuals with a disability.” This means they have met “the requisite skill, experience, education and other job-related requirements of
4 29 CFR § 1630.2(h)(2).
5 29 CFR § 1630.2(i)(1)(i).
6 29 CFR § 1630.2(i)(1)(ii)
7 29 CFR § 1630.2(j)(1)(viii).
8 29 CFR § 1630.2(g)(1)(ii).
9 29 CFR § 1630.2(g)(1)(iii).
10 29 CFR § 1630.9(e).
the employment position” and, “with or without reasonable accommodation, can perform the essential functions of such position.”11
The ADA and SSA standards for determining disability in terms of work are different. SSA does not consider an individual’s ability to work with the assistance of reasonable accommodations in its determination of whether that individual is disabled and unable to engage in SGA or work. Under the ADA, by contrast, a person qualifies as an individual with a disability for work purposes if he or she has a substantially limiting impairment (actual disability definition) or a record of a substantially limiting impairment (record of definition) and can perform the essential functions of a job with or without reasonable accommodations. Thus, under the ADA, if a person can perform his or her job with reasonable accommodations, that individual is considered disabled but able to work. However, should the person’s employer fail to provide the needed reasonable accommodations or take them away, the person is still considered a qualified individual with a disability but is unable to perform the job without the reasonable accommodations. The different SSA and ADA definitions of disability create a conundrum, as evidenced by Cleveland v. Policy Management Systems Corporation.
Cleveland v. Policy Management Systems Corporation
In Cleveland v. Policy Management Systems Corporation (1999), the Supreme Court recognized that ADA determinations and disability determinations under the Social Security Act “both help individuals with disabilities, but in different ways.”12 The petitioner, Cleveland, had a stroke during employment at Policy Management Systems Corporation. “The stroke left her impaired in her concentration, memory, and language skills.”13 Cleveland applied for SSDI benefits, stating that she was “disabled” and “unable to work.” After 3 months, Cleveland’s condition improved, and she returned to work, reporting her return to work to SSA. SSA denied her application for SSDI, noting that she had returned to work. However, 3 months after she returned to work and 4 days after SSA denied her SSDI benefits, Policy Management Systems terminated her. Cleveland then asked SSA to reconsider its denial. She offered the following reason for requesting the reconsideration: “I was terminated [by Policy Management Systems] due to my condition and I have not been able to work since. I continue to be disabled.”14 According to the Court, “she later added that she had
11 29 CFR § 1630.2(m).
12 526 U.S. at 799.
13 526 U.S. at 796.
14 526 U.S. at 797.
‘attempted to return to work in mid-April,’ that she had ‘worked for three months,’ and that Policy Management Systems terminated her because she ‘could no longer do the job’ in light of her ‘condition.’”15
SSA denied Cleveland’s request for reconsideration. She requested an SSA hearing, “reiterating that ‘I am unable to work due to my disability,’ and presenting new evidence about the extent of her injuries.”16 Approximately 10 months later, SSA awarded Cleveland SSDI benefits retroactive to the date of her stroke.17 However, the week before SSA awarded Cleveland her SSDI benefits, she filed a suit under the ADA against her former employer, Policy Management Systems Corporation, contending that it terminated her “without reasonably ‘accommodat[ing] her disability.’”18 Cleveland alleged in her ADA suit “that she requested, but was denied, accommodations such as training and additional time to complete her work,” and she submitted an affidavit to support the need for the reasonable accommodations from her treating physician.19 Rather than evaluate Cleveland’s request for reasonable accommodations on the merits, the District Court granted summary judgment, noting that by applying for and receiving SSDI benefits, Cleveland “had conceded that she was totally disabled.”20 The summary judgment prevented Cleveland from presenting any testimony on the merits regarding whether she was a “qualified individual with a disability” able to perform the essential functions of the job, with or without reasonable accommodations, the key inquiry under the ADA.21
The Fifth Circuit Court affirmed the District Court’s grant of summary judgment, stating, “The application for or the receipt of social security disability benefits creates a rebuttable presumption that the claimant or recipient of such benefits is judicially estopped from asserting that he is a ‘qualified individual with a disability [emphasis added].’”22 The Fifth Circuit Court further noted that it was “at least theoretically conceivable that under some limited and highly unusual set of circumstances the two claims would not necessarily be mutually exclusive.”23 However, it concluded this was not the case with Cleveland. It explained, “Cleveland consistently represented to the SSA that she was totally disabled, she has failed to raise a genuine issue of material fact rebutting the presumption that she is judicially estopped from now asserting that for the time in question she
15 526 U.S. at 797.
16 526 U.S. at 796.
17 526 U.S. at 796.
18 526 U.S. at 797.
19 526 U.S. at 797.
20 526 U.S. at 797.
21 526 U.S. at 805.
22 526 U.S. at 798.
23 526 U.S. at 798.
was nevertheless a ‘qualified individual with a disability’ for purposes of her ADA claim.”24
The Supreme Court vacated the Fifth Circuit Court’s decision and remanded the case for further proceedings in the trial court.25 According to the Supreme Court, courts cannot apply a special negative presumption because ADA suits and disability benefit claims do not inherently conflict, explaining that “there are too many situations in which an SSDI claim and an ADA claim can comfortably exist side by side.”26 The Supreme Court noted the differences between SSA determinations and the ADA’s requirements. According to the Court, “By way of contrast, when the SSA determines whether an individual is disabled for SSDI purposes, it does not take the possibility of ‘reasonable accommodation’ into account, nor need an applicant refer to the possibility of reasonable accommodation when she applies for SSDI [emphasis added].”27 The Court compared the SSDI standards with the requirements of ADA claims, noting, “The result is that an ADA suit claiming that the plaintiff can perform her job with reasonable accommodation may well prove consistent with an SSDI claim that the plaintiff could not perform her own job (or other jobs) without it [emphasis added].”28 The Court was persuaded by Cleveland’s statement in her brief describing the discrepancy between “her SSDI statements that she was ‘totally disabled’ and her ADA claim, that she could ‘perform the essential functions’ of her job. . . . The first statements, she says, ‘were made in a forum which does not consider the effect that reasonable workplace accommodations would have on the ability to work.’”29 Thus, since SSA does not consider reasonable accommodations in determining SSDI, an ADA plaintiff’s claim that she can perform the essential functions of a job with reasonable accommodations is consistent with an SSDI claim that she is unable to work without accommodations.
As part of its congressional oversight, the U.S. Government Accountability Office (GAO) conducted studies examining SSA’s disability programs (Bertoni, 2012; GAO, 2012, 2015; Robertson, 2002). The GAO designated federal disability programs managed by SSA and the U.S. Department of Veterans Affairs as high-risk for relying on outdated criteria in determining whether individuals qualify for benefits (GAO, 2015). SSA was designated as high-risk “in part, because their programs emphasize medical conditions in assessing work capacity without adequate consideration of work opportunities afforded by advances in medicine, technology, and job demands”
24 526 U.S. at 798.
25 526 U.S. at 807.
26 526 U.S. at 802.
27 526 U.S. at 802.
28 526 U.S. at 802-803.
29 526 U.S. at 806.
(GAO, 2012). According to a 2002 report, scientific advances as well as social changes have enhanced the potential for individuals with disabilities to work (Robertson, 2002). The report asserts that the assistive products and technologies resulting from scientific advances, which include advanced wheelchair designs, a new generation of prosthetic devices, and voice recognition systems, provide more capabilities and allow for more independence for individuals with disabilities relative to the products and technologies available in the past (Robertson, 2002). The report also notes that social change has promoted the inclusion and participation of individuals with disabilities in society, which includes the work environment (Robertson, 2002). In 2012, the GAO recommended that SSA “conduct limited and focused studies on the availability and effects of considering more fully assistive devices and workplace accommodations in its disability determinations” (GAO, 2012). The GAO concluded that “without such efforts to study how certain assistive devices and accommodations are playing a role in helping individuals with impairments stay at work or return to work, and their costs in comparison to potentially providing years of disability benefit payments, SSA may be missing an opportunity to assist individuals with disabilities to reengage in the workforce” (Bertoni, 2012).
In 2015, SSA asked the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine to convene a committee of relevant experts to provide a comprehensive analysis of the use of assistive products and technologies, including wheeled and seated mobility devices (WSMDs), upper-extremity prostheses (UEPs), and committee-selected products and technologies that pertain to hearing and to communication and speech in adults30 (see Box 1-1 for the committee’s statement of task). The 15-member committee included experts in the areas of physical medicine and rehabilitation; speech-language pathology; augmentative and alternative communication; rehabilitation science/engineering; physical therapy; occupational therapy; workplace accommodations; disability law and policy; environmental modifications; assistive devices, including WSMDs and upper-limb prostheses; and assistive devices related to hearing and communication (see Appendix D for biographical sketches of the committee members).
In carrying out its task, the Committee on the Use of Selected Assistive Products and Technologies in Eliminating or Reducing the Effects of Impairments was asked by the sponsor to address several specific topics,
including defining and explaining terms relevant to the assistive devices environment, providing an analysis of the impairment-mitigating effects of the selected assistive devices, describing the training regimen and adaptation time for the selected devices, identifying the prevalence of use of the selected devices by specific physical and mental disorders and by age,
providing an analysis of access to and availability of the selected devices, providing information on consideration of the selected devices in other programs that provide monetary benefits based on disability, and describing special considerations related to use of assistive devices by young adults as they transition from high school to the workplace. The committee’s task did not encompass reviewing the potential effects of regulatory and commercial policies on assistive technology outcomes research.
The following is a description of how SSA considers certain assistive products and technologies during its sequential evaluation process, which, as detailed above, includes assessment of whether an adult’s impairment meets or medically equals a listing (step 3), evaluation of RFC to do past work (step 4), and consideration of RFC and vocational factors to determine the ability to do other work (step 5).
Wheeled and Seated Mobility Devices
During step 3 of SSA’s sequential evaluation process, most adults who use WSMDs for ambulation have an impairment that meets or medically equals a listing because of their “inability to ambulate effectively” (SSA, 2016a). An inability to ambulate effectively is defined as “having insufficient lower extremity functioning to permit independent ambulation without the use of a hand-held assistive device(s) that limits the functioning of both upper extremities” (SSA, 2016a). Examples include the inability to walk without the use of a walker, the inability to walk a block at a reasonable pace on rough surfaces, and the inability to use standard public transportation (SSA, 2016a). Since most adults using WSMDs have an impairment that meets or medically equals a listing, SSA does not evaluate their functioning beyond step 3. Instead, policy specifies that when evaluating RFC for an individual who cannot stand or walk for the majority of a workday, SSA will focus on the individual’s manipulative and visual abilities to engage in SGA (SSA, 2016a).
During step 3 of the sequential evaluation process, most adults who use bilateral UEPs have an impairment that meets or medically equals a listing because of their “inability to perform fine and gross movements effectively” (SSA, 2016a). Examples include the inability to prepare a simple meal and feed oneself, the inability to take care of personal hygiene, and the inability
to sort and handle papers or files. In steps 4 and 5, when an individual is missing an upper extremity, RFC has been evaluated by assessing reduced strength and nonexertional capacities. An allowance is often given when standing and walking limitations are present as well. These practices were enacted when many individuals who were missing an upper limb did not use prostheses (SSA, 2016a).
SSA policy requires that individuals with lower-limb amputations wear their prostheses when ambulation is being assessed. Medical documentation is required when an individual cannot use a prosthesis. If an individual is medically capable of wearing a prosthesis and does not have an appropriate reason for failing to do so, SSA will determine that the individual is not disabled (SSA, 2016a).
During step 3, SSA does not consider an individual’s ability to hear with a hearing aid when evaluating hearing impairment (not treated by cochlear implantation). Although previous rules did require the use of a hearing aid during evaluation, many individuals did not bring one to the exam because they lacked access to such a device, had lost it, had forgotten to bring it, or had brought one that did not work. In addition, research performed in 2010 indicated that generic hearing aids were not widely available because of technological advances that allow for more highly customized hearing aids, and hearing testing in clinical practice generally was unaided (SSA, 2016a). In addition, SSA believes that evaluation with a hearing aid does not provide information on whether an individual with a hearing impairment can effectively use the device on a sustained basis or in other environments (SSA, 2016a). Therefore, SSA changed its policy to evaluate a hearing impairment at step 3 only without the use of a hearing aid to reflect the current state of practice.
When assessing RFC and ability to perform work in steps 4 and 5, SSA evaluates an individual’s ability to hear with a hearing aid if the severity of his or her hearing loss does not meet or medically equal a listing. As mentioned earlier, RFC is an individual’s maximum ability to perform sustained work activities; therefore, SSA assesses the maximum ability of the claimant when he or she is wearing a hearing aid. SSA policy specifies that “basic communication is all that is needed to do unskilled work” (SSA, 2016a). If an individual maintains basic communication skills, he or she can perform unskilled occupations “within the exertional RFC for which he or she has the capacity” (SSA, 2016a).
In step 3, SSA evaluates loss of speech for adults as the inability “to produce speech by any means [including] the use of mechanical or electronic devices that improve voice or articulation” (SSA, 2016a). Speech proficiency is evaluated on the basis of audibility, intelligibility, and functional efficiency. When an individual’s speech impairment does not meet or medically equal a listing and assessment proceeds to steps 4 and 5, his or her RFC with respect to speech and communication limitations is assessed with consideration of the individual’s vocational factors, age, education, and work experience.
The committee conducted an extensive review of the literature pertaining to assistive products and technologies. This review began with a search from years 2000 to 2016 of online databases including Medline, Embase, Cochrane Database of Systematic Reviews, and Lexis Nexis. Committee members and project staff identified additional literature and databases using traditional academic research methods and online searches throughout the course of the study. This literature review revealed a paucity of national data on the prevalence of use or the incidence of prescription of assistive products and technologies relevant to this study within the United States, largely because no single nationally representative source of data contains this information. In addition, there is little published research on the functional outcomes associated with the use of assistive products and technologies and associated services by individuals with disabilities, particularly with respect to work participation.
The committee used a variety of resources to supplement its literature review. Meeting in person five times, the committee held three public workshops and one public teleconference to hear from invited experts in areas pertinent to the study. Speakers at the workshops included experts in assistive devices pertaining to hearing and communication and speech recognition, WSMDs, UEPs, workplace accommodations, disability statistics, and the transition from high school to the workplace. The committee also heard from representatives of Kaiser Permanente, the Veterans Health Administration, Medicare, and state vocational rehabilitation services agencies, who addressed the coverage of relevant assistive products and technologies. Representatives from the Veterans Benefits Administration, Unum, Prudential Financial, and the Canada Pension Plan addressed disability insurance and benefit programs.
In addition, the committee commissioned two papers to provide additional critical analysis in areas relevant to its task. The first provides an
analysis of financial access to (funding sources for) relevant assistive products and technologies, focusing on the following public funding sources: Medicaid, Medicare, vocational rehabilitation services, and special education programs under the Individuals with Disabilities Education Act. The other provides analysis of Centers for Medicare & Medicaid Services beneficiaries receiving support for relevant assistive devices (see Appendix C). In addition, the paper includes data on the prevalence of use of assistive devices from such sources as the National Health Interview Survey Functioning and Disability Module and the SIPP. The paper provides data and information on working-age adults aged 20-67.
The committee’s work was further informed by previous National Academies reports, including Enabling America: Assessing the Role of Rehabilitation Science and Engineering (IOM, 1997), The Dynamics of Disability: Workshop on Disability in America (IOM and NRC, 2002), Improving the Social Security Disability Decision Process (IOM, 2007a), The Future of Disability in America (IOM, 2007b), and Hearing Health Care for Adults: Priorities for Improving Access and Affordability (NASEM, 2016).
Chapter 2 situates terms relevant to the assistive product and technology environment within a framework developed by the committee. Chapters 3 through 6, respectively, provide for the four selected categories of assistive products and technologies—wheeled and seated mobility devices, upper-extremity prostheses, hearing devices, and augmentative and alternative communication devices—descriptions of the various products and technologies31; clinical considerations, including effects on mitigating the impacts of impairments; and the prevalence of use. Chapter 7 provides an overview of financial access to the relevant assistive products and technologies. Chapter 8 reviews the assessment, acquisition, and use of these products and technologies in selected disability programs that provide monetary benefits. Finally, Chapter 9 presents overarching conclusions derived from the findings and conclusions provided throughout the report.
31Chapters 3, 4, and 6 include images of a variety of assistive products and technologies. The images serve as examples of device categories only and should not be considered an endorsement of specific products or manufacturers.
Bertoni, D. 2012. SSA disability programs: Progress and challenges related to modernizing: Testimony before the Subcommittee on Social Security, Committee on Ways and Means, House of Representatives. http://www.gao.gov/assets/650/648321.pdf (accessed January 18, 2017).
Brault, M. W. 2012. Americans with disabilities: 2010. Current Population Reports 7(2012): 1-131.
Firmin, J. 2016. Social Security Administration presentations relevant to the committee’s task. Presentation to the Committee on the Use of Selected Assistive Products and Technologies in Eliminating or Reducing the Effects of Impairments, Washington, DC, March 31.
GAO (U.S. Government Accountability Office). 2012. Modernizing SSA disability programs: Progress made, but key efforts warrant more management focus. Report to the chairman, Subcommittee on Social Security, Committee on Ways and Means, House of Representatives. http://www.gao.gov/assets/600/591701.pdf (accessed January 18, 2017).
GAO. 2015. High-risk series: An update. http://www.gao.gov/assets/670/668415.pdf (accessed September 16, 2016).
IOM (Institute of Medicine). 1997. Enabling America: Assessing the role of rehabilitation science and engineering. Washington, DC: National Academy Press.
IOM. 2007a. Improving the social security disability decision process. Washington, DC: The National Academies Press.
IOM. 2007b. The future of disability in America. Washington, DC: The National Academies Press.
IOM and NRC (National Research Council). 2002. The dynamics of disability: Measuring and monitoring disability for social security programs. Washington, DC: National Academy Press.
Johnson, K. L., B. Dudgeon, C. Kuehn, and W. Walker. 2007. Assistive technology use among adolescents and young adults with spina bifida. American Journal of Public Health 97(2):330-336.
Kaye, H. S., T. Kang, and M. P. LaPlante. 2000. Mobility device use in the United States. Washington, DC: National Institute on Disability and Rehabilitation Research, U.S. Department of Education.
Kraus, L. 2015. Disability statistics annual report. http://www.disabilitycompendium.org/docs/default-source/2015-compendium/annualreport_2015_final.pdf (accessed October 17, 2016).
NASEM (National Academies of Sciences, Engineering, and Medicine). 2016. Hearing health care for adults: Priorities for improving access and affordability. Washington, DC: The National Academies Press.
Robertson, R. E. 2002. SSA disability programs: Fully updating disability criteria has implications for program design. http://www.gao.gov/new.items/d02919t.pdf (accessed January 18, 2017).
SSA (U.S. Social Security Administration). 2012a. POMS DI 00115.015 Definitions of disability. https://secure.ssa.gov/poms.nsf/lnx/0400115015 (accessed July 16, 2017).
SSA. 2012b. POMS DI 24505.001 Individual must have a medically determinable severe impairment. https://secure.ssa.gov/poms.nsf/lnx/0424505001 (accessed September 16, 2016).
SSA. 2015. POMS DI 10520.001 Impairment-related work expenses (IRWE). https://secure.ssa.gov/poms.nsf/lnx/0410520001 (accessed December 12, 2016).
SSA. 2016a (unpublished). Background for IOM on SSA policy and processes related to assistive devices and workplace reasonable accommodations. Baltimore, MD: SSA.
SSA. 2016b. Fast facts and figures about Social Security, 2016. https://www.ssa.gov/policy/docs/chartbooks/fast_facts/2016/fast_facts16.pdf (accessed September 15, 2016).
SSA. 2016c. POMS DI 24505.015 Finding disability based on the listing of impairments. https://secure.ssa.gov/poms.nsf/lnx/0424505015 (accessed September 15, 2016).
SSA. 2017. Substantial gainful activity. https://www.ssa.gov/oact/cola/sga.html (accessed January 23, 2017).
Wixon, B., and A. Strand. 2013. Identifying SSA’s sequential disability determination steps using administrative data. https://www.ssa.gov/policy/docs/rsnotes/rsn2013-01.html (accessed January 19, 2017).
This page intentionally left blank.