The following statutes from the State of Michigan are provided to you by Social Security Lawyer
Michigan for informational purposes only. These serve as examples to cases in which you may be
entitled to settlements due to existing statutes. Please review them and
contact Social Security Lawyer Michigan if you have any questions.
CODE OF FEDERAL REGULATIONS
TITLE 20--EMPLOYEES' BENEFITS
CHAPTER III--SOCIAL SECURITY ADMINISTRATION
PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE
(1950-)
SUBPART P--DETERMINING DISABILITY AND BLINDNESS
GENERAL
Current through May 26, 2003; 68 FR 28646
§404.1501 Scope of subpart.
In order for you to become entitled to any
benefits based upon disability or blindness or to have a period of disability
established, you must be disabled or blind as defined in title II of the Social
Security Act.This Subpart explains how
we determine whether you are disabled or blind.We discuss a "period of disability" in Subpart D of this
Part.We have organized the rules in the
following way.
(a) We define general terms, then discuss who
makes our disability determinations and state that disability determinations
made under other programs are not binding on
our determinations.
(b) We explain the term "disability"
and note some of the major factors that are considered in determining whether
you are disabled in § §404.1505-404.1510.
(c) Sections 404.1512-404.1518 contain our
rules on evidence.We explain your
responsibilities for submitting evidence of your impairment, state what we
consider to be acceptable sources of medical evidence, and describe what
information should be included in medical reports.
(d) Our general rules on evaluating disability
if you are filing a new application are stated in § §404.1520 through 404.1523.We describe the steps that we go through and
the order in which they are considered.
(e) Our rules on medical considerations are
found in § §404.1525-404.1530.We explain in these rules--
(1) The purpose of the Listing of Impairments
found in Appendix 1 of this subpart and how to use it;
(2) What we mean by the term "medical
equivalence" and how we determine medical equivalence;
(3) The effect of a conclusion by your
physician that you are disabled;
(4) What we mean by symptoms, signs, and
laboratory findings;
(5) How we evaluate pain and other
symptoms;and
(6) The effect on your benefits if you fail to
follow treatment that is expected to restore
your ability to work, and how we apply the rule.
(f) In § §404.1545-404.1546 we explain what we mean by the term "residual
functional capacity," state when an assessment of residual functional
capacity is required, and who may make it.
(g) Our rules on vocational considerations are
found in § §404.1560 through
404.1569a.We explain when vocational
factors must be considered along with the medical evidence, discuss the role of
residual functional capacity in evaluating your ability to work, discuss the
vocational factors of age, education, and work experience, describe what we
mean by work which exists in the national economy, discuss the amount of
exertion and the type of skill required for work, describe and tell how to use
the Medical-Vocational Guidelines in appendix 2 of this subpart, and explain
when, for purposes of applying the guidelines in appendix 2, we consider the
limitations or restrictions imposed by your impairment(s) and related symptoms
to be exertional, nonexertional, or a combination of both.
(h) Our rules on substantial gainful activity
are found in § §404.1571-
404.1574.These explain what we mean by
substantial gainful activity and how we evaluate your work activity.
(i) In § §404.1577, 404.1578, and 404.1579, we explain the special rules covering
disability for widows, widowers, and surviving divorced spouses for monthly benefits payable for months prior to
January 1991, and in § §404.1581
through 404.1587 we discuss disability due to blindness.
(j) Our rules on when disability continues and
stops are contained in § §404.1579 and
404.1588 through 404.1598.We explain
what your responsibilities are in telling us of any events that may cause a
change in your disability status, when you may have a trial work period, and
when we will review to see if you are still disabled.We also explain how we consider the issue of
medical improvement (and the exceptions to medical improvement) in deciding
whether you are still disabled.
<General
Materials (GM) - References, Annotations, or Tables>
20 C. F.
R. §404.1501
20 CFR
§404.1501
END OF
DOCUMENT
CODE OF FEDERAL REGULATIONS
TITLE 20--EMPLOYEES' BENEFITS
CHAPTER III--SOCIAL SECURITY ADMINISTRATION
PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE
(1950-)
SUBPART P--DETERMINING DISABILITY AND BLINDNESS
GENERAL
Current through May 26, 2003; 68 FR 28646
§404.1502 General definitions and terms for
this subpart.
As used in the subpart--
Acceptable medical source refers to one of the
sources described in §404.1513(a) who
provides evidence about your impairments.It includes treating sources, nontreating sources, and nonexamining
sources.
Commissioner means the Commissioner of Social Security
or his or her authorized designee.
Medical sources refers to acceptable medical
sources, or other health care providers who are not acceptable medical sources.
Nonexamining source means a physician, psychologist,
or other acceptable medical source who has not examined you but provides a
medical or other opinion in your case.At the administrative law judge hearing and Appeals Council levels of
the administrative review process, it includes State agency medical and
psychological consultants, other program physicians and psychologists, and
medical experts we consult.See §404.1527.
Nontreating source means a physician,
psychologist, or other acceptable medical source who has examined you but does
not have, or did not have, an ongoing treatment relationship with you.The term includes an acceptable medical
source who is a consultative examiner for us, when the consultative examiner is
not your treating source.See §404.1527.
State agency means that agency of a State
which has been designated by the State to carry out the disability or blindness
determination function.
Treating source means your own physician,
psychologist, or other acceptable medical source who provides you, or has
provided you, with medical treatment or evaluation and who has, or has had, an
ongoing treatment relationship with you.Generally, we will consider that you have an ongoing treatment
relationship with an acceptable medical source when the medical evidence
establishes that you see, or have seen, the source with a frequency consistent
with accepted medical practice for the type of treatment and/or evaluation required for your medical condition(s).We may consider an acceptable medical source
who has treated or evaluated you only a few times or only after long intervals
(e.g., twice a year) to be your treating source if the nature and frequency of
the treatment or evaluation is typical for your condition(s).We will not consider an acceptable medical
source to be your treating source if your relationship with the source is not
based on your medical need for treatment or evaluation, but solely on your need
to obtain a report in support of your claim for disability.In such a case, we will consider the
acceptable medical source to be a nontreating source.
We or us refers to either the Social Security
Administration or the State agency making the disability or blindness
determination.
You or your means, as appropriate, the person
who applies for benefits or for a period of disability, the person for whom an
application is filed, or the person who is receiving benefits based on
disability or blindness.
<General
Materials (GM) - References, Annotations, or Tables>
20 C. F.
R. §404.1502
20 CFR
§404.1502
END OF
DOCUMENT
CODE OF FEDERAL REGULATIONS
TITLE 20--EMPLOYEES' BENEFITS
CHAPTER III--SOCIAL SECURITY ADMINISTRATION
PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950-)
SUBPART P--DETERMINING DISABILITY AND BLINDNESS
DETERMINATIONS
Current through May 26, 2003; 68 FR 28646
§404.1503 Who makes disability and blindness
determinations.
(a) State agencies.State agencies make disability and blindness
determinations for the Commissioner for most persons living in the State. State
agencies make these disability and blindness determinations under regulations
containing performance standards and other administrative requirements relating
to the disability and blindness determination function. States have the option
of turning the function over to the Federal Government if they no longer want
to make disability determinations.Also,
the Commissioner may take the function away from any State which has
substantially failed to make disability and
blindness determinations in accordance with these regulations.Subpart Q of this part contains the rules the
States must follow in making disability and blindness determinations.
(b) Social Security Administration.The Social Security Administration will make
disability and blindness determinations for--
(1) Any person living in a State which is not
making for the Commissioner any disability and blindness determinations or
which is not making those determinations for the class of claimants to which
that person belongs;and
(2) Any person living outside the United
States.
(c) What determinations are authorized.The Commissioner has authorized the State
agencies and the Social Security Administration to make determinations about--
(1) Whether you are disabled or blind;
(2) The date your disability or blindness
began;and
(3) The date your disability or blindness
stopped.
(d) Review of State Agency
determinations.On review of a State
agency determination or redetermination of disability or blindness we may find
that--
(1) You are, or are not, disabled or blind, regardless
of what the State agency found;
(2) your disability or blindness began earlier
or later than the date found by the State
agency;and
(3) Your disability or blindness stopped
earlier or later than the date found by the State agency.
(e) Initial determinations for mental
impairments.An initial determination by
a State agency or the Social Security Administration that you are not disabled
(or a Social Security Administration review of a State agency's initial
determination), in any case where there is evidence which indicates the
existence of a mental impairment, will be made only after every reasonable
effort has been made to ensure that a qualified psychiatrist or psychologist
has completed the medical portion of the case review and any applicable
residual functional capacity assessment.(See §404.1616 for the
qualifications we consider necessary for a psychologist to be a psychological
consultant and §404.1617 for what we
consider "reasonable effort".)If the services of qualified psychiatrists or psychologists cannot be
obtained because of impediments at the State level, the Commissioner may
contract directly for the services.In a
case where there is evidence of mental and nonmental impairments and a
qualified psychologist serves as a psychological consultant, the psychologist
will evaluate only the mental impairment, and a physician will evaluate the
nonmental impairment.
<General
Materials (GM) - References, Annotations, or Tables>
20 C. F.
R. §404.1503
20 CFR
§404.1503
END OF
DOCUMENT
CODE OF FEDERAL REGULATIONS
TITLE 20--EMPLOYEES' BENEFITS
CHAPTER III--SOCIAL SECURITY ADMINISTRATION
PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE
(1950-)
SUBPART P--DETERMINING DISABILITY AND BLINDNESS
DETERMINATIONS
Current through May 26, 2003; 68 FR 28646
§404.1503a Program integrity.
We will not use in our program any individual
or entity, except to provide existing medical evidence, who is currently
excluded, suspended, or otherwise barred from participation in the Medicare or
Medicaid programs, or any other Federal or Federally-assisted program;whose license to provide health care services
is currently revoked or suspended by any State licensing authority pursuant to
adequate due process procedures for reasons bearing on professional competence,
professional conduct, or financial integrity;or who, until a final determination is made, has surrendered such a
license while formal disciplinary proceedings
involving professional conduct are pending.By individual or entity we mean a medical or psychological consultant,
consultative examination provider, or diagnostic test facility.Also see § §404.1519 and 404.1519g(b).
<General
Materials (GM) - References, Annotations, or Tables>
20 C. F.
R. §404.1503a
20 CFR
§404.1503a
END OF
DOCUMENT
CODE OF FEDERAL REGULATIONS
TITLE 20--EMPLOYEES' BENEFITS
CHAPTER III--SOCIAL SECURITY ADMINISTRATION
PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE
(1950-)
SUBPART P--DETERMINING DISABILITY AND BLINDNESS
DETERMINATIONS
Current through May 26, 2003; 68 FR 28646
§404.1504 Determinations by other
organizations and agencies.
A decision by any nongovernmental agency or
any other governmental agency about whether you are disabled or blind is based
on its rules and is not our decision about whether you are disabled or
blind.We must make a disability or
blindness determination based on social security law.Therefore, a determination made by another
agency that you are disabled or blind is not binding on us.
<General
Materials (GM) - References, Annotations, or Tables>
20 C. F.
R. §404.1504
20 CFR
§404.1504
END OF
DOCUMENT
CODE OF FEDERAL REGULATIONS
TITLE 20--EMPLOYEES' BENEFITS
CHAPTER III--SOCIAL SECURITY ADMINISTRATION
PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE
(1950-)
SUBPART P--DETERMINING DISABILITY AND BLINDNESS
DEFINITION OF DISABILITY
Current through May 26, 2003; 68 FR 28646
§404.1505 Basic definition of disability.
(a) The law defines disability as the
inability to do 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 of
not less than 12 months.To meet this
definition, you must have a severe impairment, which makes you unable to do
your previous work or any other substantial gainful activity which exists in
the national economy.To determine
whether you are able to do any other work, we consider your residual functional
capacity and your age, education, and work experience.We will use this definition of disability if
you are applying for a period of disability, or disability insurance benefits
as a disabled worker, or child's insurance benefits based on disability before
age 22 or, with respect to disability benefits payable for months after
December 1990, as a widow, widower, or surviving divorced spouse.
(b) There are different rules for determining
disability for individuals who are statutorily blind.We discuss these in § §404.1581 through 404.1587. There are also
different rules for determining disability for widows, widowers, and surviving
divorced spouses for monthly benefits for months prior to January 1991.We discuss these rules in § §404.1577, 404.1578, and 404.1579.
<General
Materials (GM) - References, Annotations, or Tables>
20 C. F.
R. §404.1505
20 CFR
§404.1505
END OF
DOCUMENT
CODE OF FEDERAL REGULATIONS
TITLE 20--EMPLOYEES' BENEFITS
CHAPTER III--SOCIAL SECURITY ADMINISTRATION
PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE
(1950-)
SUBPART P--DETERMINING DISABILITY AND BLINDNESS
DEFINITION OF DISABILITY
Current through May 26, 2003; 68 FR 28646
§404.1506 When we will not consider your
impairment.
(a) Permanent exclusion of felony-related
impairment.In determining whether you
are under a disability, we will not consider any physical or mental impairment,
or any increase in severity (aggravation) of a preexisting impairment, which
arises in connection with your commission of a felony after October 19, 1980,
if you are subsequently convicted of this crime.Your subsequent conviction will invalidate
any prior determination establishing disability if that determination was based
upon any impairment, or aggravation, which we must exclude under this rule.
(b)
Limited use of impairment arising in prison.In determining whether you are under a disability for purposes of
benefit payments, we will not consider any physical or mental impairment, or
any increase in severity (aggravation) of a preexisting impairment, which
arises in connection with your confinement in a jail, prison, or other penal
institution or correctional facility for conviction of a felony committed after
October 19, 1980.The exclusion of the
impairment, or aggravation, applies in determining disability for benefits
payable for any month during which you are confined.This rule does not preclude the establishment
of a period of disability based upon the impairment or aggravation.You may become entitled to benefits upon
release from prison provided that you apply and are under a disability at the
time.
(c) Felonious offenses.We will consider an offense a felony if--
(1) It is a felony under applicable law;or
(2) In a jurisdiction which does not classify
any crime as a felony, it is an offense punishable by death or imprisonment for
a term exceeding one year.
(d) Confinement.In general, a jail, prison, or other penal
institution or correctional facility is a facility which is under the control
and jurisdiction of the agency in charge of the penal system or in which
convicted criminals can be incarcerated.Confinement in such a facility continues as long as you are under a
sentence of confinement and have not been released due to parole or pardon.You are considered confined even though you are temporarily or
intermittently outside of the facility (e.g., on work release, attending
school, or hospitalized).
<General
Materials (GM) - References, Annotations, or Tables>
20 C. F.
R. §404.1506
20 CFR
§404.1506
END OF
DOCUMENT
CODE OF FEDERAL REGULATIONS
TITLE 20--EMPLOYEES' BENEFITS
CHAPTER III--SOCIAL SECURITY ADMINISTRATION
PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE
(1950-)
SUBPART P--DETERMINING DISABILITY AND BLINDNESS
DEFINITION OF DISABILITY
Current through May 26, 2003; 68 FR 28646
§404.1508 What is needed to show an impairment.
If you are not doing substantial gainful
activity, we always look first at your physical or mental impairment(s) to
determine whether you are disabled or blind.Your impairment must result from anatomical, physiological, or
psychological abnormalities which can be shown by medically acceptable clinical
and laboratory diagnostic techniques (see §404.1527).A physical or mental
impairment must be established by medical evidence consisting of signs,
symptoms, and laboratory findings, not only by your statement of symptoms. (See
§404.1528 for further information about
what we mean by symptoms, signs, and
laboratory findings.)
