Disability Benefits for People over 65
By Pitt Dickey

Remember Sysiphus in Greek mythology?  He was  condemned  forever to push a rock up a hill and then have it roll back down again.    Congress  turned older  disabled folks into Sysiphus  by raising the age for Social Security Administration (SSA)  retirement benefits  from 65 to 67.   The increase in  retirement age will hit people   right in their  wallet.  The law gradually increases full retirement age from 65 to age 67.   People born in 1938  will be the first to come under the delayed retirement law beginning in 2003.  By 2027 the law raising  retirement age to 67 will be effect and cover anyone born after 1960.  The change  in the law doesn't effect the early retirement age of 62.

The SSA issued rules in November 2003 for evaluating   disability claims for people between  ages 65   and  67.  The SSA had  to start deciding Disability Insurance benefits claims for people over 65 once Congress pushed the retirement age up the hill.  This column will look at  the new rules for  disabled people over 65 who  can't work before they attain their over age 65 retirement age.

The SSA is going to apply the same general test to folks over age 65 who are seeking disability benefits as it currently  does for people in the age 60 to 64 age group.   The SSA will have to consider any impairment that the claimant has,  including impairments that generally effect people over age 65.

There is a five step sequential  test the SSA uses  to determine if the person over age 65 is entitled to Social Security Disability benefits.  Step 1. Is the person working?   If the claimant is working and earning above a certain monthly dollar  amount,  he will not be considered disabled regardless of his health problems.   Step 2. Does the individual have a severe impairment? An impairment  is considered "severe'' if it significantly limits an individual's physical or mental abilities to do basic work activities.  The SSA rules note that for disability claims from persons over age 65 that certain impairments are more likely to occur due to age such as "osteoporosis, osteoarthritis, certain cancers, adult onset diabetes, memory impairments, hypertension and impairments of memory or vision."    The SSA rules note that it is incorrect to disregard any of the individual's age related impairments because they are"normal" for the person's age. Step 3. Does the person have an impairment which meets or equals the impairments on the SSA's Listing of impairments?  The SSA has a listing of diagnoses of major health problems.   If the claimant has that medical diagnosis with  certain signs and symptoms,   the SSA is required to approve their disability claim. These Listings are very stringent and are difficult to meet.  Step 4. Does the person have an impairment that prevent him from performing his past relevant work?    This means can the person do the work he has done in the past 15 years?  Step 5. Can the person do other work if they can't do their past work?    If the person can't do their past work and they are older than 65,  the SSA has two special profiles to test the ability of the older person to work.   The "arduous unskilled physical labor profile" is used when the person is not working, has a history of at least 35 years of arduous unskilled physical labor,  can no longer perform his past job and has no more than a 6th grade education.   The other profile called the "no work experience profile" which  is for a person over 55 who has no prior work experience, and has a less than 11th grade education. If either of these profiles apply then the SSA must find the person disabled.

If the person over 65 doesn't meet either of the two profiles listed above, then the SSA will apply additional tests. If the person over 65 is limited to sedentary or light work they will be found to be disabled unless their past work experience gave them transferable job skills or they have a high school or greater education which would allow them to do skilled work.  A person over the age of 65 who is limited to medium work will be found to be disabled if they have less than a high school education and no prior work experience.

The SSA recognizes that typical health impairments for the elderly such as osteoporosis and other conditions described above tend to increase with advancing age.   The existing SSA rules require health impairments to last at least twelve months.  The new rules direct the SSA to recognize that such age related health problems will typically last the 12 months instead of improving. Due to the wide range of health problems of those over 65, the new rules direct the  SSA to consider  purchasing a  general  medical evaluations for an over 65  disability applicant  instead of specific medical exams  such as an orthopaedic exam.

The SSA rules also note that it may be more difficult for persons over 65 to provide medical histories and information due to age related impairments.  The SSA will take additional steps to find out about an elderly applicant for disability beyond the usual steps taken for younger applicants.    If a person over 65 does not appear to be cooperating with the SSA, the rules require additional contact with the person or relatives who might be able to advise why the elderly person is not cooperating with the SSA's evaluation.

Considering the change in the law, the new SSA rules are very humane.  However,  it can take well over a year to process a disability claim.  There is a real possibility that the disabled elderly will not have their claim completed before they reach age 67 or pass away from complications of their health problems.  Welcome to Sysiphus Land.

Copyright © Pitt Dickey 11/19/2003