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What are the Legal requirements for proving Social Security Disability?

If you understand that Social Security Disability is a Federal Administrative decision determined by a Federal Administrative Law Judge, then what must you prove to be granted disability benefits? A claimant is eligible to receive Social Security disability benefits when that person is unable 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 continuous period of not less than 12 months.”  42 U.S.C.A. Section 423 (d)(1)(A). Beyond that, the person: [I]s 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 regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him or whether he would be hired if he applied for work.  For purposes of the preceding sentences (with respect to any individual) “work which exists in the national economy” means work which exists in significant numbers either in a region where such individual lives or in several regions of the country. 42 U.S.C.A. Section 423(d)(2)(A). The SSA has adopted a set of guidelines designed to achieve consistency and disability determinations.  See, 20 CFR §404.1520. Under these guidelines, the Commissioner must make the following five determinations in a sequential fashion: (1) whether the claimant is currently engaged in substantial gain activity; (2), if not, whether he has a severe impairment; (3) if so, whether that impairment meets or equals a listed impairment in Appendix I of the applicable regulations; (4) if not, whether the impairment prevents the performance of past relevant work; and (5) whether the impairment prevents the performance of any other work existing in the national economy.  20 C.F.R. §404.1520 (b-f). If his impairment meets or equals a listed impairment, the claimant is “disabled.” 20 C.F.R. §404.1520(d).  If this is not the case, then the claimant can still show he is disabled by showing his impairment prevents him from performing past relevant work. 20 C.F.R. §404.1520(e)(1993). By satisfying either step 3 or 4, the claim establishes a prima facie case of disability.   At most, the claimant in the Social Security disability case has only the burden of proving that they can no longer perform their past relevant work.  Thus, the burden of proof is upon the defendant (here the Social Security Administration is the Defendant) to show some other work that the plaintiff can perform despite his medical impairments.  Grant v. Schweiker, 699 F.2d 189 (4th Cir. 1983).  When the burden shifts to the Commissioner of the Social Security Administration, this leads to the fifth and final inquiry in the sequence; whether the impairment prevents the performance of any work existing in the national economy.  Hall v. Harris, 658 F2d 260, 264 (4th Cir. 1981); Hunter v. Sullivan, 993 F2d 31, 35 (4th Cir. 1993). If the claimant reaches step 5, the burden shifts to the Commissioner of Social Security to show that other jobs exist in the national economy that the claimant can perform considering her age, education and work experience.  20 C.F.R. §404.1520(f). Thus, if you can demonstrate that you either meet or equal a listed impairment or that you can no longer perform your past relevant work then the burden of proof shifts to Social Security to show that you can perform other jobs depending on your age, education and work experience. If you have questions about these legal requirements contact our office and speak to Susan O’Malley a NC Bar Certified Social Security Disability Specialist.


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