This article discusses the difficulty substantial numbers of low income West Virginians encounter in establishing their eligibility for Disability Insurance Benefits under section 233 (d) of the Social Security Act. These persons are characteristically middle-aged, unskilled workers who lose their employment as the result of a mental or physical condition of a non-traumatic, chronic origin. Because of their medical condition, combined with their advancing age and lack of skills, these persons are "disabled", yet they are denied Disability Insurance Benefits. An analysis of twenty-six "difficult" claims denied on the first filing, but refiled, reveals a pattern of unjustified denials in the pri or filings. The claims were denied for two reasons: (1) erroneous interpretation by the Social Security Administration of the medical proof of disability requirements of Section 223 (d) and faulty evaluation of medical evidence; and (2) unreasoned application of two statutory eligibility criteria-the "national employability test" and the "current insurance requirement." The bulk of this article will explain this pattern of error in interpretation and application of section 223 (d) so that the exact nature of the errors may be understood. Once the problem areas of the law and regulations are identified, they may be overcome, to some extent, by advocacy, or corrected through reform measures undertaken by the Administration itself, by Congress, or in the courts.
James B. Haviland & Michael B. Glomb,
The Disability Insurance Benefits Program and Low Income Claimants in Appalachia,
W. Va. L. Rev.
Available at: https://researchrepository.wvu.edu/wvlr/vol73/iss2/3