Cardiovascular Disability Updating the Social Security Listings (2010) / Chapter Skim
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2 Social Security Disability Programs and Procedures
2 Social Security Disability Programs and Procedures
Pages 39-52
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From page 39... ...
Readers familiar with Social Security disability may wish to proceed directly to the next chapter. However, it may be useful to review some key features of the programs that the committee considered and treated as givens in their approach to evaluating and recommending changes in the cardiovascular listings, as follows: • The statutory definition of disability used to decide if a claimant should receive disability benefits is strict -- essentially, it requires an adult claimant to have a medically determinable impairment or impairments that prevent the ability to work for a continuous period of not less than 12 months or is expected to result in death.
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From page 40... ...
, where they serve as an admin istrative expedient to quickly identify allowances, that is, cases in which the impairment is considered severe enough to prevent the claimant from doing any work. Thus the Listings help SSA avoid subjecting obviously disabled claimants to a time- and resource intensive, in-depth assessment of their residual functional capacity and vocational issues that must be performed at later steps of the sequential evaluation process.
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Considering the individual's residual functional capacity (RFC) and Yes the physical and mental demands of the work he or she did in the past, is the Not individual able to perform past relevant work?
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SSA DISABILITY PROGRAMS SSA pays disability benefits through two programs: Social Security Disability Insurance (SSDI)
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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." • A child under the age of 18 is considered disabled if he or she has "a medically determinable physical or mental impairment, which results in marked and severe functional limitations, and 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." DISABILITY EVALUATION DECISION PROCESS SSA uses a sequential evaluation process to determine whether a claimant is disabled. The evaluation stops at any step in the sequence at which a decision about disability is made.
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From page 44... ...
Rather, adult claims not allowed at the Listings step proceed to Step 4, which consider the claimant's ability to perform past relevant work, and if necessary, to Step 5, which considers the claimant's ability to do other work that exists in significant numbers in the national economy. At Step 4, SSA assesses the claimant's residual functional capacity (RFC)
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FIGURE 2-2 Disability evaluation process for Supplemental Security Income children.
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THE LISTING OF IMPAIRMENTS History and Purpose SSA has used a listing of impairments to ease the administrative burden of determining the functional capacity of each claimant since the disability freeze program, the immediate predecessor to the SSDI program, began in 1955.1 The Listings were, and are, a set of serious medical conditions used to identify claimants with medical conditions of such severity that they could be considered disabled without further evaluation. SSA updates the Listings periodically.
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From page 47... ...
Rather than beginning the revision process by proposing new or revised rules in a Notice of Proposed Rulemaking (NPRM) in the federal Register, SSA first issues an Advance Notice of Proposed Rulemaking, which announces its intention to update a 2 The 14 body systems are as follows: musculoskeletal system, special senses and speech, respiratory system, cardiovascular system, digestive system, genitourinary impairments, hematological disorders, skin disorders, endocrine system, impairments that affect multiple body systems, neurological, mental disorders, malignant neoplastic diseases, and immune system disorders.
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After these additional steps in the process, SSA drafts proposed rules and publishes an NPRM for public comment before issuing final rules. INITIAL DECISIONS Social Security disability claims are initially processed through a network of local SSA field offices and DDSs.
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The Appeals Council may also issue its own decision affirming, modifying, or reversing the ALJ decision or remand the case to an ALJ for more proceedings at the hearing level. There were 89,000 Appeals Council reviews in fiscal year 2009 (SSA, 2009c)
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and other evidence, including statements or reports from the claimant, the treating or examining physician, psychologist, or other source, and others about the claimant's medical history, diagnosis, prescribed treatment, daily activities, efforts to work, and any other infor 3 Program Operations Manual System (POMS) , SSA's procedural manual, cites fractures, burns, and gunshot wounds as examples of MIE impairments (Program Operations Manual System, Section DI 13005.055)
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2009a. annual statistical report on the Social Se curity disability Insurance Program, 00.
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