DI 24505.001 Individual Must Have a Medically Determinable Severe Impairment
References: Social Security Act—Section 223(d) and Section 1614(a)
Regulations No. 4—Sections 404.1520, 404.1521, 404.1523, 404.1525, 404.1526 Regulations No. 16—Sections 416.920, 416.921, 416.923, 416.925, and 416.926.
A. The Statutory Requirement (See DI 24515.065)
In determining, for initial entitlement to benefits, whether an individual is disabled, we follow a sequential evaluation process whereby current work activity, severity and duration of impairment, ability to do past work, and ability to do other work (in light of the individual's age, education and work experience) are considered, in that order. In determining continuing entitlement to benefits, the adjudicator, with appropriate consideration of the medical improvement review standard, also follows a sequential evaluation process which includes the “not severe impairment” concept. Fundamental to these processes is the statutory requirement that to be found disabled, an individual must be unable to engage in “any substantial gainful activity by reason of any medically determinable physical or mental impairment...” (emphasis added). In reporting on the Social Security Amendments of 1954 which first introduced this basic definition of disability into the Act, the Senate Committee on Finance stated that the definition required that there be a “medically determinable impairment of serious proportions ,” that is, “of a nature and degree of severity sufficient to justify its consideration as the cause of failure to obtain any substantial gainful work.”
B. Definition of not Severe Impairment(s)
At the second step of sequential evaluation, it must be determined whether medical evidence establishes a physical or mental impairment or combination of impairments of sufficient severity as to be the basis of a finding of inability to engage in any substantial gainful activity (SGA). When medical evidence establishes only a slight abnormality or a combination of slight abnormalities which would have no more than a minimum effect on an individual's ability to work, such impairment(s) will be found “not severe,” and a determination of “not disabled” will be made without consideration of vocational factors. In such an instance, the person's impairment(s) would have no more than a minimal effect on his or her physical or mental ability(ies) to perform basic work activities, so a determination of “not disabled” would result even if the individual's age, education, or work experience were specifically considered. Thus, even if an individual were of advanced age, had minimal education, and a limited work experience, an impairment found to be not severe would not prevent him or her from engaging in SGA.
NOTE: This policy is not applicable for aged aliens who are 72 years of age or older. See DI 25015.025B.
C. Basic Work Activities
The severity requirement cannot be satisfied when medical evidence shows that the person has the ability to perform basic work activities, as required in most jobs. Examples of these are walking, standing, sitting lifting, pushing, pulling, reaching, carrying or handling; seeing, hearing, and speaking; understanding, carrying out, and remembering simple instructions; use of judgment, responding appropriately to supervision, coworkers, and usual work situations; and dealing with changes in a routine work setting. Thus, these basic work factors are inherent in making a determination that an individual does not have a severe medical impairment.