Aspects of Disability Decision Making: Data and Materials

DI: Disability Insurance under Title II of the SocialSecurity Act.DI Worker: An individual entitled to DisabilityInsurance benefits based on his or her own earningsaccount.Disability: For purposes of Title II (OASDI) benefitsand of Title XVI (SSI) benefits for adults,disability is the inability to engage in any substantialgainful activity by reason of any medicallydeterminable impairment which can be expectedto result in death or can be expected to last for acontinuous period of not less than 12 months. Aperson must not only be unable to do his or herprevious work but cannot, considering age, education,and work experience, engage in any otherkind of substantial gainful work that exists in thenational economy. It is immaterial whether suchwork exists in the immediate area, or whether aspecific job vacancy exists, or whether the workerwould be hired if he or she applied for work. ForSSI disabled child benefits, a child under age 18 isconsidered disabled if he or she has any medicallydeterminable physical or mental impairment(s)which result(s) in marked and severe functionallimitations, and which can be expected to last for acontinuous period of not less than 12 months.Disability Determination Services (DDS): TheState agency which makes the initial and reconsiderationdetermination of whether a claimant isdisabled or a beneficiary continues to be disabledwithin the meaning of the law.Disability examiner: An employee of a StateDisability Determination Services who collectsand analyzes medical evidence and, in conjunctionwith a medical professional, makes the determinationon a claimant’s disability.Duration: To be eligible for benefits, a claimantmust have a disabling impairment that has lastedor is expected to last for a continuous period of atleast 12 months or to result in death. (See sequentialevaluation process.)eDib: SSA’s electronic disability case processingsystem that allows the agency to process claims ina fully electronic environment. Paper copies of anyevidence or documents are converted to and storedin an electronic format.Equals the Listing: A step in the sequential evaluationprocess. An impairment may be found to be“medically equivalent” to an impairment(s) foundin the Listing of Impairments if the relevantmedical signs, symptoms, and laboratory findingsare equal in severity to those of a listed impairment.(See sequential evaluation and Listing ofImpairments.)Examiner: See Disability Examiner.Hearing: The level following reconsideration inthe administrative review process. The hearing is ade novo procedure at which the claimant and/or therepresentative may appear in person, submit newevidence, examine the evidence used in makingthe determination under review, give testimony,and present and question witnesses. The hearing ison the record but is informal and non-adversarial.Hearing office: SSA’s Office of Disability Adjudicationand Review has 161 hearing offices (includingseven satellite offices)around the country wherehearings are held.Incidence: The number of persons awarded benefitsin a specified period of time, per 1,000 of aspecified population. For DI benefits, the incidencerate is the number of awards in a given year per1,000 persons insured for disability benefits.Listing of Impairments: The Listing of Impairmentscontains specific medical findings that eitherestablish a diagnosis or confirm the existence of animpairment. The Listing of Impairments is dividedinto two parts – Part A describes, for each majorbody system, impairments that are consideredsevere enough to prevent an adult from doing anygainful activity. Part B contains additional criteriathat apply only to the evaluation of impairmentsof individuals under the age of 18. An impairmentthat meets or equals the criteria in the Listings issufficient to establish that an individual who is notworking is disabled within the meaning of the law.(See sequential evaluation.)Medical expert: A physician or mental health professionalwho provides impartial expert opinionat the hearing level of the SSA disability claimsprocess.Medical Improvement Review Standard: Theevaluation criteria used to determine whethera beneficiary continues to be disabled. Medicalimprovement will be found when there is a decreaseAspects of Disability Decision Making: Data and Materials 121