The Federal Social Security Act, Title XIV, and the state statute require that a person
be found to be wholly prevented from working because of a permanent illness, defect,
or injury in order to qualify for APTD. Thus the basic requrement is that a person
can be considered eligible on this factor when he has a physical or mental impairment,
or a combination of impairments, which is expected to continue and which prevent him
from engaging in useful work that is within his competence and that exists in the
community in which he lives. Each of these terms is defined below.
Impairment. This means a disease process, a birth defect, or injury, as established
by medical findings. Or more than one disease, defect, or injury that together constitutes
a major impairment.
Permanent. This term is defined as a physiological, anatomical, or emotional impairment
for which there is at present no known cure or reasonable expectation for improvement.
This major condition, disease, or loss, either congenital or acquired, is expected
to continue throughout the lifetime of the person because the condition is not likely
to respond to any known therapeutic procedure; or known treatment that would relieve
or remove the condition is unavailable or inadvisable; or the person refuses treatment
and his decision is reasonable; and without the treatment the condition will remain
static or become progressively worse. The term “permanent” is qualified in several ways. It does not imply that there is no hope that the person
will ever improve, as persons sometimes respond favorably after a poor prognosis.
The following qualifications apply:
The advances in medical science and the discovery of new drugs may bring about the
improvement or recovery of the person.
The condition may be one in which proper medical treatment might succeed in bringing
about improvement but treatment is unavailable, inadvisable, or reasonably refused.
Treatment is considered unavailable when all local and state resources for treatment
have been explored and found not to exist or not to be accessible.
Treatment is considered unavailable when there is known treatment but such treatment
is medically unsound because of the person's age or other diagnosis.
Treatment is reasonably refused if the only available therapy is such that it involves
a high degree of the risk of life or essential organs or faculties; or that in view
of previous medical diagnosis and other health conditions, it holds little or no likelihood
of proving effective; or if in the opinion of the State Medical Review Team there
exists genuine fear; or a person's religious belief prohibits treatment. A person's
refusal of treatment may occasionally constitute inadvisability. For example, if a
person refuses treatment because of a genuine fear, treatment would usually be considered
jThe outcome of treatment appears uncertain and therefore the finding of “permanent” can be made later because of changes resulting from treatment.
Total. The term total means entirely or completely. In APTD total disability means
that the person is wholly prevented from working in his usual occupation or in other
useful work for which he is qualified and which is available in the community. Each
of these terms is also defined.
Useful Work. Useful work is a job in which a person works for another, or self-employment;
or in the case of a homemaker, homemaking activities. That is, useful work includes:
Work that is an essential job or bona fide work opportunity, so that if the person
in this position did not do the work, the employer would hire someone else to do it.
Work that is productive and results in benefits to others.
Work that requires some skill or attention to accomplish.
Work that is usually done for pay or is performed as contributing member of the family
group such as working in the family crop. This includes similar activities performed
for another such as a neighbor or other family member.
Homemaking Activities: For homemaking, useful work consists of those activites required
in maintaining a home and in providing care for children. A person who is considered
a homemaker must be one who assumes the management of a home, including decision-making,
for at least one person in addition to herself or himself. Major homemaking activities
Shopping for food and clothing.
Planning, preparing meals, and washing dishes.
Cleaning house (mopping, sweeping, dusting, and moving furniture).
Making beds, washing and ironing clothes.
Also, in some instances, carrying water, bringing in fuel, and building fires.
Care of children when there are infants and young children in the home for whom the
person is responsible. Care of children includes: dressing and bathing, feeding, lifting
and carrying, training and supervision, as well as physical protection from danger
While the wife and mother is usually the homemaker, the responsibility of these activities
must in some instances be assumed by another person in the home. In these cases the
test of homemaking activities will be applied to the person actually responsible for
and assuming these duties. Also if the homemaker is performing these duties in some
small part but they are in major part left undone because of the permanent impairment
of the homemaker, so as to endanger health and decency of the family members, the
homemaker will be considered to be wholly prevented from working in her usual occupation.
Nonuseful Work. Nonuseful work consists primarily of:
A made-up job, given to the person as a matter of sympathy, for which no one else
would be hired if the person were to leave or be unable to continue.
A hobby undertaken as therapy or a way of passing the time.
Retraining under the direction of the vocational rehabilitation counselor and the
Work Within Competence and Existing in Community. The term “within his competence” means that a person has the work skills, obtained either by education or experience,
which enable him to perform a certain task or kind of work. However, the fact that
a person can no longer use these work skills in the same kind of work in which he
has been employed does not mean that he may not be able to use them in similar or
related work. The person's work history, education, and community in which he lives
tell the story about his being able to find alternate employment.
Existence of work in the community refers to the requirement that a job or opportunity
for self-employment must be present in the community in which the applicant lives.
The fact that a job does exist elsewhere for which the client is qualified in terms
of work skills and experience does not provide the client with his usual work unless
of course he wishes to move to the location at which this work is available. Thus he will be wholly prevented from working in his usual job in this circumstance.
On the other hand, if a person is physically and mentally competent to do work which
is similar to his usual occupation, even though it is less skilled work, and the work
is available where he lives, then this person is unemployed rather than prevented
from working because of his impairment. An example of both competence and the existence
of work in the community is a situation in which the person has been doing office
work, either secretarial or bookkeeping, and suffers some impairment so that she can
no longer move about to the degree required in her duties; if, however, this person
can serve as a telephone operator in an office, not being required to be mobile, then
an alternate job is available for her if one exists in that community where she lives.
However, a person with little or no education who has always done manual labor and
who becomes unable to do strenuous work of this kind is prevented by his illness or
injury from performing his usual work and has no skill that will enable him to take
a sedentary job.