Definition of Disability

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Overview of the Disability Process
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Definition of Disability

• Inability to engage in any substantial gainful
  activity by reason of any medically determinable
  physical or mental impairment 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.
• Social Security Act, 223(d)/1614(a)(3)

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And. . .

• An individual shall be disabled only if his
  physical or mental impairment or impairments are
  of such severity that he is not only unable to do
  his previous work but cannot, considering his
  age, education, and work experience, engage in
  any other kind of substantial gainful work which
  exists in the national economy. . . .

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Sequential Evaluation Process?Adults

• 1. SGA? NO ? Go to 2. YES ? Not
  disabled
• 2. Severe? YES ? Go to 3. NO ? Not
  disabled
• 3. Meets/equals listing? YES ? Disabled
• NO ? ? ? RFC Assessment
• 4. PRW? NO ? Go to 5. YES ? Not disabled
• 5. Other work? YES ? Not disabled NO ?
  Disabled

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Step 1SGA?

• Inability to engage in any substantial gainful
  activity. . .
• Nonblind level 940/month 2008
• Blind level 1,570/month 2008

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Severe?

• Slight abnormality or combination of slight
  abnormalities
• More than minimal impact on basic work
  activities, e.g.--
• walk, stand, sit, lift, carry
• see, hear, speak
• understand instructions, get along with coworkers

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Step 3 Meet or equal?

• . . . only if his physical or mental impairment
  is of such severity . . . .
• Listing of Impairments (the listings)
• Meets
• Medically equals

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The Listings

• Part A Age 18, some lt18
• Part B lt Age 18 only
• Body Systems
• Musculoskeletal Special Senses
  and Speech
• Respiratory
  Cardiovascular
• Digestive
  Genitourinary
• Hematological Skin
• Endocrine Multiple
  Body
• Neurological Mental
• Malignant Neoplastic Immune
• Growth (Part B only)

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Residual FunctionalCapacity (RFC)

• For steps 4 and 5
• Physical and mental abilities
• e.g., sit, stand, walk, push, pull vision,
  environment understand, remember, carry out
  instructions, respond to supervision, get along
  with coworkers/others
• 8 hrs/day, 5 days/wk

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Step 4 Past Relevant Work?

• . . . is not only unable to do his previous work
  . . . .
• 15 years
• SGA
• As performed and as generally performed

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Step 5 Other Work?

• . . . but cannot, considering his age,
• education, and work experience, engage
• in any other kind of substantial gainful
• work which exists in the national
• economy. . . .

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Other Work

• RFC, age, education, work experience
• Medical/Vocational Guidelines (Grids)

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• Monte Hetland, M.D
• Pediatric Medical Officer
• Office of Disability Programs