IS SOCIAL SECURITY A "SHADOW UNEMPLOYMENT PROGRAM"?

I am sickened when I hear journalists or critics of the Social Security disability program making outrageous claims.  One of the current hot buttons is the claim that Social Security disability has become "a shadow unemployment benefit program."  This is such hogwash!

Social Security disability is governed by a complex system of federal regulations, consisting not only of the Social Security Act but Parts 1-99 of the 20 Code of Federal Regulations (20 CFR).  These regulations have set up mandatory processes and rules of evidence which absolutely prohibit disability benefits to anyone who is not (a) insured under the Social Security Act (b) unable to work at any substantial gainful activity (c) disabled for at least 12 consecutive months and (d) able to provide objective medical evidence proving the disabling condition.  

From the time of application, the typical process to get approved for Social Security disability can take 24 to 36 months or longer. That's a poor unemployment program!  A person will often go without food, housing or essential medical care during the months it takes to have his or her claim decided.  Most of my clients didn't get laid off and then start looking for disability benefits.  Most of my clients had well paying careers, often earning $50,000 a year or more--before becoming disabled--and seeking a few hundred dollars a month in disability benefits.  Unemployment, indeed! 

About 70 percent of all disability applications are denied by the state agency which makes the initial decision.  Then, the claimant must appear before a federal administrative law judge to prove that he/she has a disabling condition, using objective medical evidence.

20 CFR 404.1529 requires a severe medically determinable impairment, for which objective medical evidence is required and  this impairment must reasonably be expected to last for a minimum of 12 months or more.

20 CFR 404.1545 requires the claimant to present objective medial evidence to establish a Residual Functional Capacity (RFC).  Depending on the claimant's age and education, the RFC generally must preclude even the ability to engage in substantial gainful activity at the sedentary level (the easiest exertion level).

20 CFR 1520 establishes a five-step mandatory process that decision makers must follow in determining whether a claimant is eligible for disability benefits:

Step 1:  Is the claimant now engaged in any substantial gainful activity?  If so, he is not eligible for Social Security disability benefits.  Denied.  Period.

Step 2:  Does the claimant have a medically determinable severe impairment?  If not, she is not eligible for disability benefits.  "Medically determinable" requires objective medical evidence:  X-ray, MRI, CAT scan, laboratory testing, etc., not just a subjective complaint of pain or symptoms.  Social Security will often perform their own medical exam.

Step 3:  Does the claimant meet a listing?  (In my experience, about 1 out of 100 claimants will meet a Listing).  If not, what is the claimant's Residual Functional Capacity (RFC)?  In short, what does the medical evidence determine that the claimant's maximum ability is with regard to the ability to perform work-like activities?  For persons below age 50, the symptoms must be severe enough to prevent any type of full-time work that exists in the U.S. economy?  (See Step 5 below).

Step 4:  Based on the claimant's RFC, age, education and job skills, is the claimant able to perform any of his or her past relevant work?  If so, he or she will be denied.  If not, the process moves on to Step 5, which is even more difficult.

Step 5:  Can the claimant perform any other work which exists in the United States economy?  If it is found that the claimant can perform even unskilled sedentary work, he/she will be denied benefits.  Thus, if a claimant is found able to perform such simple, unskilled jobs as silverware wrapper, ticket seller, usher, packager, tele-marketer, surveillance system monitor or food and beverage order clerk, no benefits are available. (The fact that no jobs are available in these industries cannot be considered).

Anyone who makes the statement that the Social Security disability program is becoming a "shadow unemployment benefit program" is showing a profound ignorance of the law, the 20 Code of Federal Regulations, the Social Security Act and the rigorous process that Social Security uses to screen, investigate and deny claimants.

In most cases, if the "journalists" who write such fables would have done at least 30 minutes of research on the adjudication process for Social Security disability claims, their conclusions would have been far different.


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