The American Association for Disability Policy Reform    

—   rehabilitation first   —


Rules that Fail

SUMMARY:

In determining whether or not an applicant is disabled, the Social Security Administration uses five steps: (1) If the applicant is earning more than $1,130/month (or $1,820/month if blind), he or she is considered not disabled.   (2) If the applicant has no apparent physical or psychological disease, he or she is considered not disabled.   (3) If the applicant's condition meets the requirements of any of a set of listed conditions, he or she is considered disabled.   (4) If the applicant is able to do his or her past work, he or she is considered not disabled.   (5) If the applicant is able to do any other work, he or she is considered not disabled, otherwise he or she is considered to be disabled.

Here are the flaws in the process: (1) Determining whether or not an applicant is earning (by his or her own effort) more than $1,130/month requires an analysis of the economic value of his or her work efforts - something with Social Security workers are neither trained for nor have the time to do.   (2) Determining whether or not the applicant has a physical or psychological disease is usually (but not always) straightforward for those who have medical care but, because the Social Security Administration's examinations are cursory and superficial, those who lack medical care may not be able to pass this step.   Thus, this step discriminates against the poor.   (3) The Social Security Administration's list of "disabling" conditions (deafness, confinement to a wheelchair, etc.) are far too simple to determine the presence or absence of disability, as evidenced by the hundreds of thousands of persons who would be considered "disabled" under the rules but actually do work.   They also fail to recognize the millions of combinations of diseases (such as heart disease with lung disease or any disease with obesity) that can, in fact, be disabling.   Because many of their requirements include expensive medical testing, they also discriminate against the poor.   (4) The past work test classifies as not disabled those who are able to do jobs that they once did and no longer exist (e.g. elevator operator) or or jobs that are illegal (e.g. manufacture amphetamines).   (5) The last step uses a set of rules (e.g. a person age 50 or beyond who hasn't done a desk job in the past and is now limited to desk work can't learn a desk job and must be considered disabled) that have no basis in fact.   In addition, the Social Security Administration's occupational database was incomplete and inaccurate when it was first published and is now almost entirely 30 years out of date.

We should never expect to be able to determine whether or not real (complex) people are disabled with such crude rules.   It is therefore not surprising to find that these rules fail to determine who is disabled and who is not.


DETAILS

The Five-step Process

The Social Security Administration uses a five-step process in trying to decide whether or not an applicant is disabled.   The decision steps are:

  1. If the applicant is earning more than $1,130 a month by his or her own effort, he or she is considered to be demonstrating an ability to work and his or her application is denied.
  2. If the applicant has no demonstrable physical or mental disease that could affect his or her ability to work, his or her application is denied.
  3. If the applicant's condition meets the requirements of one of a list of about 300 specified conditions (commonly called "the disability listings"), he or she is considered incapable of earning anything and is therefore considered to be disabled and his or her application is approved.
  4. If the applicant is able to do any of the jobs he or she did in the past 15 years, he or she is considered able to work and his or her application is denied.
  5. If the applicant is able to do any job that is available is significant numbers in the regional economy, he or she is considered to be able to work and his or her application is denied.   If not, his or her application is approved.

Let's consider each of the five steps in detail:

Step 1: Is the applicant earning more than $1,130 a month by his or her own effort?   When an applicant is earning nothing, the decision is easy.   However, when an applicant is continuing to work, the Social Security Administration is faced with trying to determine the economic value of the applicant's own work activities.   To do this well requires sending a person to the workplace to determine what the applicant's work activities actually are and then calculating the economic value of those activities.   (Note that many jobs include a variety of work activities.)   The Administration does not have the manpower or the personnel trained to do this.   In cases where the applicant is working, the applicant's earnings are usually assumed to equal the value of his or her work.   Except when the applicant is doing no work, this step is almost never done well.

Step 2: Does the person have a demonstrable physical or mental disease that could affect his or her ability to work?   For those who have obvious conditions that could affect their ability to work, the decision is easy.   Unfortunately, those who have not been able to afford medical care are often not able to demonstrate such conditions and are placed at a disadvantage.   The Social Security Administration's physical and mental examinations are limited to superficial office-based observations of the 1950s and are of little value (details).   Thus, this step discriminates against the poor (details).

Step 3: Does the applicant have a condition that meets the requirements of one of the conditions specified in the "disability listings."   Here are some examples of listed conditions (a) the presence of a spinal cord injury with "sustained disturbance of gross and dextrous movements, or gait and station" (listing 11.08), (b) profoundly deaf (listing 2.08), (c) having an I.Q. between 60 and 70 and another physical or mental impairment imposing significant work-related limitation of function.   For the exact wording of these and the other listings, see the Code of Federal Regulations (20 C.F.R. 404, Subpart P, Appendix 1).

The listings have many problems, primarily,

Occasionally the argument is made that the listings are justified because they speed case processing and increase the uniformity of decisions.   Consider the following possible listing: "All persons whose Social Security numbers end in an even number are disabled and the others are not."   Such a listing would greatly speed processing and increase uniformity.   The public expects much better: prompt decisions that accurately separate those who are disabled from those who are not.

The listings are crude rules for determining whether or not a person is able to work.   We should never have expected such crude rules to work, and they don't.   Altogether they have failed as tests for disability and we have no hope that they are ever going to become adequate.

Step 4: Is the applicant able to do his or her past work?   This test was imposed by Congress in 1967 in reaction to certain judicial decisions and in an effort to curb the cost of the disability program.   It hasn't worked.   Here's why:

Step 5: Is the applicant is able to do any job that is available is significant numbers in the regional economy?

The Social Security Administration has 82 rules for determining whether or not a person can perform work other than his/her previous work (found in the Code of Federal Regulations at 20 C.F.R. Part 404, Subpart P, Appendix 2).   The rules consider the claimant's age, education, previous work experience and, in a few cases ability to speak English, in order to make a decision.   For a person with a high school education and no special skills who is unable to do his or her past work, the most commonly used rules that result in a finding of disability are:

The first rule assumes that no person age 50 or older who has not done sedentary work in the previous 15 years is able to learn to sit at a desk and answer the phone, or be a receptionist, or sit at a desk and assemble small items, or take reservations, or be a clerk, or provide customer telephone support, or type reports, or fill out forms, or learn to do any other kind of sedentary work.   We found a cat (details) and a dog that can answer a phone (details).

The second rule assumes that no person age 55 or older who has not done light work in the previous 15 years is able to learn to stand at a counter and take fast food orders, or stand and make adjustments to a machine, or stand and record readings from meters, or work as a cashier, or deal cards in a casino, or work in a highway toll booth, or do any other kind of light work.

On the other hand, consider Nola Ochs, who earned a college degree at the age of 95 and a Master's degree at the age of 98 and kept taking classes until the age of 100.   Walter Zable was Chief Executive Officer of his company, with annual sales $1.2 billion, until he died in June 2012 at the age of 97.   Others have mastered new skills and continued to work at advanced ages.   With motivation and some assistance, disabled persons can do much more than the vocational rules assume.   Altogether, the vocational rules lack a scientific basis and force decision-makers to declare persons disabled who might, with reasonable help, return to work.

Finally, the Social Security Administration's job data is hopelessly inadequate.   The job descriptions are all out of date (details) and current reliable job numbers do not exist.


CONCLUSION

None of the five steps consistently works well and altogether they fail as a method of determining who is able to work and who is not.   They are no substitute for an individualized approach to disability claimants by trained persons whose first goal should be to return the individual to productive work when that is possible.


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Last updated on 12/13/16.