Social Security Disability is a program intended to replace a worker’s income when medical impairments make the worker unable to continue. This seems straightforward enough, but it’s no secret that the age of the worker is a huge factor affecting a worker’s likelihood of being approved for benefits. Years ago, I attended a presentation made by a longtime Social Security Disability attorney, who said: “You’ve heard that the top 3 factors affecting real estate value are location, location, location. In disability law, the top 3 factors affecting case strength are age, age, age.” This may be a bit of an exaggeration, but there is no doubt that the rules of the disability adjudication favor older workers. This feature is rooted in the history of the program, which still affects how claims are decided today.
At Keller & Keller, we represent individuals of all ages. If you are over 50, we will make sure Social Security is appropriately applying the advantageous rules that can help you get approved. If you are under 50, you may be facing more of an uphill battle, but we will fight that much harder on your behalf. Even though age is important, disability payments should be available to workers of all ages who develop impairments that prevent future employment.
Social Security Disability History
To understand why age is so important to a claim, we can look to the history of the Social Security Disability program. As a mechanism for income and wealth redistribution, it should be no surprise that it has always involved controversy. The Social Security program started in the mid-1930s and included retirement benefits, but disability benefits were too controversial to be included at the outset. Detractors were concerned about the costs and efficient administration of any disability program.
However, in 1956, Social Security began making payments to disabled workers over the age of 50. Disability was defined as an impairment which prevented the person from performing any substantial gainful occupation for the rest of the person’s life – essentially complete and permanent disability.
In 1960, benefits became available to workers under 50 years old. About five years after that, Social Security dropped the “lifelong disability” requirement and created the durational rule that is still in effect. Disability benefits are now payable when an impairment is expected to make the worker unable to work for twelve months or longer. These changes expanded the availability of Social Security Disability benefits.
But in 1980, the pendulum began to swing the other way. Leaders voiced renewed concerns about the costs and viability of the disability program and instituted reforms to address this. Most visibly, Social Security significantly increased its focus on Continuing Disability Reviews, which involve an evaluation of whether a benefit recipient remains disabled. This initiative was intended to reduce overall program costs by removing supposedly non-disabled individuals from the disability rolls. Social Security also added incentives for recipients to return to work.
Today, the most impactful 1980s-era reform is the institution of the medical-vocational guidelines or so-called “grid rules.” Generally, the grid rules favor older individuals and provide that someone between the ages of 50-54 should be considered disabled if they can no longer perform their past work or apply their skills in another occupation even if they are otherwise physically capable of the demands of a sedentary occupation. Someone over age 55 can be considered disabled even if they are physically capable of a light-duty occupation if they can no longer perform their past work or utilize transferable skills. While the grid rules do not take us all the way back to 1956 when ONLY those over 50 could be approved, they surely make Social Security’s decision makers much more likely to approve claimants over 50 years old.
While the grid rules remain, the initiative for more Continuing Disability Reviews faced backlash with publicity of stories involving severely debilitated individuals who lost their disability benefits, causing them to face extreme financial hardship. This backlash resulted in further changes to Social Security Disability law. Now, someone’s disability benefits cannot be ceased merely because a decision maker sees things differently and decides a disability recipient should no longer be receiving benefits – a showing of definitive medical improvement is required. While Continuing Disability Reviews are still regularly performed, rules provide that benefits cannot be ceased arbitrarily.
How This History Affects Claims Today
After the Social Security Disability program began, it changed relatively quickly from a program only available to those over 50 and since 1960 disabled workers of all ages have been able to receive benefits. However, this very early history of restricting benefits to those over 50 still seems relevant in reflecting policy goals and attitudes of the program’s decision makers. The black letter law of the grid rules formally creates a rule system in which older individuals are more likely to be approved. Under the grid rules, a claim brought by a 49-year-old and a claim brought by a 51-year-old could result in different outcomes even with otherwise identical fact patterns.
Other factors favor approval of older workers in less direct ways. The major finding made in a disability case is the assessment of the individual’s Residual Functional Capacity, or RFC. The major factors the decision maker is asked to assess relate to exertional limitations – how much someone can lift, how long they can stand, and how far they can walk. Exertional limitations may commonly make a 58-year-old incapable of performing more than light duty work, which could lead to an approval under the grid rules. But Social Security’s vocational experts will say that even extreme limitations with lifting, standing, and walking still allow for sedentary work, which is likely to result in the denial of a claim brought by a 48-year-old. With the focus on standing, walking, and lifting, Social Security’s decision makers give less attention to the mental limitations or periods of intermittent incapacity that can leave youngers unable to sustain regular work.
While Social Security long ago changed the “lifelong disability” requirement to the current twelve-month durational rule, decision makers steeped in the history of the disability program may still be more reluctant to approve younger individuals who have more years left to collect benefits and thus seek more in the lifetime value of a disability finding. Longtime concerns about the costs of the program have not gone away despite its years of existence during strong economic times. Historical difficulty in ceasing benefits through Continuing Disability Reviews may also factor in and cause a decision maker to be less willing to approve a younger individual when some medical improvement is possible, even if the twelve-month durational rule would seemingly be satisfied.
Public health and the economy continue to evolve. As advocates for the disabled, we strive for fair outcomes for today’s clients, even when dealing with a disability program still affected by a design based on policy goals from the mid-20th century. Whether you are close to retirement age or became disabled after a relatively short time in the workforce, Keller & Keller will work to get you the benefits which should be available to you in a fair and just disability system.
