SSA and conducted by the American Psychiatric Association (APA)—of SSA’s standards and guidelines used in the determination of claims based on mental disorders. Building upon this base, the paper reviews the conceptual model and taxonomy of the World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF) (WHO, 2001) and related WHO disability assessment instruments, and their potential utility in the redesign of the determination process, and toward a cohesive agenda for research. The paper is intended to stimulate an agenda for research to inform future modifications of the disability determination whether or not a formal redesign is undertaken.

BACKGROUND

Statutory Definition of Disability

The foundation of the SSA’s two disability programs is the statutory definition of disability in the Social Security Act. The same definition applies to both the SSDI and the SSI programs and is the standard that the SSA puts into operation for the determination of claims for disability benefits. The definition can be changed only by an act of Congress. According to the Social Security Act, the definition of disability is “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 on not less than 12 months” (Section 223(d)(1)(A)).

The term “substantial gainful activity” means work that is remunerated at a rate specified by regulations. As of January 1, 2001, the rate is $740 per month. In other words, an individual may not be earning more than $740 per month in order to be eligible for disability benefits. The statute further states that the physical or mental impairments must be so severe that the claimant cannot do any work in the national economy that exists in substantial numbers. It does not matter whether or not jobs are available in the local region or whether or not the person would actually be hired if a job existed. If a type of job exists in substantial numbers somewhere in the country that the claimant could do, then she or he is not given disability benefits.

Conversely, consideration is given to the person’s age, educational level, and past work experience. A person nearing retirement age is treated differently by SSA than a younger, working age individual. The older person is more likely to be considered favorably for disability benefits. A person with a grade school education is not expected to be able to work at an available occupation that requires advanced educational expertise, and a person with a work history of manual labor is not expected to



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