Factors Used in Determining If You Have A Severe Impairment / Disability

Examining Work Functions, Environmental Conditions and Mental Functions in Social Security Disability / SSI Benefit Claims Adjudication

Since a medically determinable impairment must be the basis of a finding of disability, step two in the five step disability evaluation process is to determine whether a severe impairment is present.  

For an impairment or combination to be severe, it must significantly limit the individual’s physical or mental capacity to perform one or more basic work activities as required in most jobs. The following list identifies all physical, environmental and mental work activities. 

Work Functions, including the ability to:

• Lift 
• Carry 
• Stand 
• Walk 
• Sit 
• Push 
• Pull 
• Climb 
• Balance 
• Stoop 
• Kneel 
• Crouch 
• Crawl 
• Reach 
• Handle 
• Finger 
• Feel 
• See 
• Hear 
• Speak 

Environment Conditions, including exposure to:

• Heat 
• Cold  
• Wetness 
• Noise 
• Vibration 
• Hazards 
• Humidity 

Mental Functions, including the inability or limited ability to:

• Remember location, work-like procedures 
• Carry out instructions 
• Perform activities within a schedule 
• Be punctual 
• Sustain ordinary routine without special supervision 
• Work in coordination/proximity to others 
• Accept instructions/respond appropriately to criticism 
• Maintain socially appropriate behavior 
• Set realistic goals 
• Aware of normal hazards/take precautions 
• Travel in unfamiliar places/use public transportation 
• Adhere to basic standards of neatness/cleanliness 
• Understand, remember instructions 
• Maintain attention/concentration 
• Make independent plans 
• Make work-related decisions 
• Interact appropriately with others 
• Ask questions/assistance 
• Respond appropriately to changes 

Impairment is considered “not severe” if it has no more than a minimal effect on an individual’s physical or mental ability to do basic work activities. Example: Amputation of a leg above the knee would significantly limit several of the physical work activities (stand, walk, climb, etc.). On the other hand, a headache will generally make an individual feel less than well, but he would normally be able to carry out any of the work functions in the list above.

If an individual has multiple impairments and each individual impairment is “not severe”, the combined impact on the individual’s work activities must be considered before a decision of “not severe” is made. In other words, would the minimal limitations of each of the impairments, if combined, result in more than a minimal limitation on the individuals work activities?*

If the medical evidence (symptoms, signs, and laboratory finding) does not establish impairment(s) that has more than minimal effect on the individual’s work activities, a decision of “not disabled” is appropriate. The decision at this step is based on medical findings alone, vocational factors are not considered. To make a decision at this step, all necessary medical evidence must be obtained. A decision cannot be made based on “gut feeling,” but must be supported by the necessary findings. 

Source: SSD Resource Manual 

So how will this information help me win my disability claim? 

From this list included in the “work functions” section above, it is easy to see why it is so important to thoroughly complete your work history form, listing the requirement for walking, standing, sitting, climbing, stooping, kneeling, crouching, crawling, handling, reaching and writing on each job. 

Generally, your disability examiner will be able to determine the environmental factors you are exposed to based on the type of work that you do, but if you know that you have been exposed to other environmental condition in your individual situation that your industry in general would not be expected to be exposed to, then you should make it a point to mention this on your work history for that particular job so that it will be considered in the decision that the examiner will make in determining whether or not you can return to that type of work.

Your friends, neighbors, spouse or third party collateral sources will be sent forms to complete or will be spoken to on the phone if you are alleging a mental impairment. If their responses to the questions they are asked will include such words as noted in the “mental functions” section, it would be to your benefit. For example, instead of saying, “Jerry doesn’t go outside much because he doesn’t feel like it”, they could say, “Jerry used to go outside all the time, but now he tells me he doesn’t like to be around other people. He says they make him nervous and he knows they are talking about him anyway.” 

* Editor’s note: With reference to the last paragraph regarding how combination impairments are to be treated, it has been my experience that disability examiners do not handle combination impairments very well, and rarely are non-severe impairments combined to produce a severe impairment or a positive decision for claimants. The one exception might be in the case of a mentally retarded individual who has other physical impairments (section 12.05 of the Listings of Impairments). So, if you have a combination of impairments, which when taken together, render you disabled, these type cases tend to get better decisions in front of an Administrative Law Judge (i.e. when you appeal your denial after the initial and reconsideration level). You may want to retain representation by a skilled social security disability representative or attorney in your state.