How would you define “disability”? For millions of Americans, the definition of this word is of vital importance. Unable to support themselves through gainful employment because of mental or physical impairments, these individuals must rely upon government programs designed to supplement their incomes.
Social Security Disability Insurance (SSDI) is an insurance program. A person’s entitlement to SSDI depends, primarily, upon their work history and whether or not they are “disabled” within the meaning of the Social Security Act. Work history is a factor because workers pay into the Social Security system. A worker, in essence, pays a premium for SSDI by paying into the SSDI program through payroll contributions. A millionaire could receive SSDI benefits.
Supplemental Security Income (SSI) is a means-tested program. In other words, SSI is a welfare program intended to provide income to categorically needed individuals. Receipt of SSI, like SSDI, may also turn on whether or not the applicant is “disabled” within the meaning of the Social Security Act.
The Social Security Act defines “disability” as follows: “inability 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 a continuous period of not less than 12 months.” The Social Security Administration defines the phrase “substantial gainful activity” as the ability to earn more than $500 per month. Those individuals who can earn more than $500 a month are presumed to be able to engage in substantial gainful activity.
Recently, a federal court of appeals was presented with a case in which the Court had to construe the definition of “disability” as that word is used in the Social Security Act. In the case, entitled Walton versus Apfel, Mr. Walton suffered from schizophrenia and depression and his condition, a mental impairment, had lasted for more than twelve months. Mr. Walton had been a teacher; however, his condition prevented him from performing his teaching duties. His condition did not, however, prevent him from working as a cashier at a supermarket, and he began working in such a position more than five months after his disability onset but before twelve months had elapsed since the onset of his disability.
The Social Security Administration argued that because Mr. Walton was able to engage in substantial gainful activity within twelve months of the onset of his disability, he was not “disabled” within the meaning of the Act and was not entitled to SSDI benefits. Mr. Walton argued that he was unable to engage in gainful activity for five months – the waiting period imposed by the Act – and his disability had lasted for more than twelve months. So, he was disabled.
The question the Court resolved was, does the phrase “which has lasted or can be expected to last for a continuous period of not less than twelve months” modify “substantial gainful activity” or “impairment” or both, as those terms are used in the definition of the word disability. A third grader would probably be able to tell you the Court’s decision given the issue presented, since it is in third grade when students typically learn sentence structure.
The phrase modifies the word “impairment,” not the phrase “substantial gainful activity”; accordingly, the Court ruled that Mr. Walton was entitled to SSDI benefits since he had contributed to the SSDI program, he was unable to engage in gainful employment for five months, and his impairment had last for more than twelve months. As simple as this decision may seem, its import could be significant.
Social Security has appealed the decision to the Supreme Court of the United States, and the Supreme Court has agreed to hear the matter. In its request to the Supreme Court, Social Security claimed that the Walton decision could cost the Social Security program an additional $80 billion dollars nationwide. Currently, the Administration denies a disability claim if the applicant is able to engage in substantially gainful activity within twelve months of the date of onset of the disability. The reduction of that period from twelve to five months would cost $80 billion, accordingly to the Social Security Administration. The Administration provided no support for their monetary claim.
I will keep you posted on the Supreme Court’s decision, which is expected this spring.