SUMMARY OF SOCIAL SECURITY DISABILITY LAW
August 27, 2008
A SUMMARY OF SOCIAL SECURITY DISABILITY LAW
A claimant seeking disability benefits is considered disabled if he or she is incapable of engaging in any substantial gainful activity (paid work) due to a physical or mental impairment that has lasted, or can be expected to last for a period of not less than twelve (12) months. 42 U.S.C., Sec. 423 (d)(1)(A). To qualify for disability benefits under the Social Security Act, the claimant must be unable to perform his or her previous work, or any other kind of substantial work. Dousewicz v. Harris, 646 F.2d 771, 772 (2d Cir.1981). The burden of proving disability is on the plaintiff. 42 U.S.C., Sec. 423(d)(5); See, e.g., Aubuef v. Schweiker, 649 F.2d 107, 111 (2d Cir.1981). However, once the plaintiff has shown that his or her impairment(s) prevents his or her return to his or her prior employment, the plaintiff has established a prima facie case, and the burden shifts to the Commissioner. Bluvband v. Heckler, 730 F.2d 886, 891 (2d Cir.1984). The Commissioner must then produce evidence to show the existence of alternate substantial gainful work which exists in the national economy, and which the plaintiff could perform, considering not only his or her physical capability, but his or her age, education, experience, and training as well. Parker v. Harris, 626 F.2d 225, 231 (2d Cir.1980); See also, Dumas v. Schweiker, 712 F.2d 1545, 1550 (2d Cir.1983).
The Commissioner, in evaluating disability claims, utilizes a five step sequence set forth in 20 C.F.R. Sec 404.1520. The Act provides that the Commissioner’s findings as to any fact, if supported by substantial evidence, shall be conclusive. 42 U.S.C. Sect. 405(g); Richardson v. Perales, 402 U.S. 389, 401 (1971); Donato v. Commissioner of Health and Human Services, 721 F.2d 414, 418 (2d Cir.1983).
“In reviewing a final decision of the Commissioner, a district court must determine whether the correct legal standards were applied and whether substantial evidence supports the decision.” Butts v. Barnhart, 388 F.3d 377, 384 (2d Cir.2004). The former determination requires the Court to ask, inter alia, whether “the claimant has had a full hearing under the [Commissioner's] regulations and in accordance with the beneficent purposes of the Act.” Echevarria v. Secretary of Health & Human Servs., 685 F.2d 751, 755 (2d Cir.1982) (citation and internal quotation marks omitted). The latter determination requires the Court to ask whether the decision is supported by “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Curry v. Apfel, 209 F.3d 117, 122 (2d Cir.2000) (quoting Richardson v. Perales, 402 U.S. 389 (1971)).
An Administrative Law Judge must evaluate a disability claim in accordance with a well established, five-step process:
1. At the first step, the agency will find non-disability unless the claimant shows that he is not working at a “substantial gainful activity”;
2. At step two, the Social Security Administration (SSA) will find non-disability unless the claimant shows that he has a “severe impairment,” defined as “any impairment or combination of impairments which significantly limits [the claimant's] physical or mental ability to do basic work activities”;
3. At step three, the agency determines whether the impairment which enabled the claimant to qualify for benefits under step two is on the list of impairments presumed severe enough to render one disabled; if so, the claimant qualifies;
4. If the claimant’s impairment is not on the list, the inquiry proceeds to step four, at which the SSA assesses whether the claimant can do his previous work; unless he shows that he cannot, he is determined not to be disabled; and
5. If the claimant does not qualify at the fourth stage, the fifth, and final, step requires the SSA to consider so-called “vocational factors” (the claimant’s age, education, and past work experience), and to determine whether the claimant is capable of performing other jobs existing in significant numbers in the national economy.
In addition to the disability requirements, a claimant also has to meet earnings requirements to qualify for Social Security Disability. Generally, to qualify an adult worker has to have worked at least ten years in their lifetime and for at least five of the past ten years prior to becoming disabled. There are special earnings rules for younger claimants.
Further information, including the list of impairments, can be found at the Social Security Administration’s website at ssa.gov.
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