STEP ONE simply determines if an individual is "working (engaging in substantial gainful activity)" according to the SSA definition. Earning more than $830 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.
STEP TWO implies that the post-polio syndrome disability must be severe enough to significantly limit one’s ability to perform basic work activities needed to do most jobs.
For example, the SSA must be able to determine that some or all of the activities below have been compromised as a result of the disability:
- walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling;
- seeing, hearing or speaking;
- understanding/carrying out and remembering simple instructions;
- use of judgment;
- responding appropriately to supervision, co-workers and usual work situations;
- dealing with changes in a routine work setting.
STEP THREE is Social Security disability adjudication. Postpolio sequelae refer to multiple physical and mental disorders that may be demonstrated by polio survivors many years after an acute polio infection. Motor weakness is the most common residual of acute polio infection and is usually manifested by observable weakness, muscle atrophy, and reduced peripheral reflexes. In the absence of contrary evidence, as long as the medical findings support a reasonable medical nexus between the prior polio infection and the present manifestation of any one or combination of the disorders discussed in Social Security Ruling 03-1p (early advanced degenerative arthritis, sleep disorders, respiratory insufficiency and various mental disorders), the SSA will find the claimant has postpolio sequelae. Furthermore, the criteria found in medical listing 11.11 (anterior poliomyelitis) are applicable to postpolio sequelae. If any of the following are present, the claimant will be found to be disabled: 1. Persistent difficulty with swallowing or breathing; 2. Unintelligible speech; and 3. Disorganization of motor function as found in medical listing 11.04B, i.e., significant and persistent disorganization of motor function in two extremities, resulting in sustained disturbance of gross and dexterous movements, or gait and station. The findings presented by the claimant may meet the preceding or be found to “medically equate” the preceding.
STEP FOUR explores the ability of an individual to perform work done in the past despite the post-polio syndrome disability. If the SSA finds that a person can do past work, benefits are denied. If the person cannot, then The Process proceeds to the fifth and final step.
STEP FIVE looks at age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. To determine post-polio syndrome disability, the SSA enlists vocational rules, which vary according to age. For example, if a person is:
- Under age 50 and, as a result of the symptoms of post-polio syndrome, unable to perform what the SSA calls sedentary work, then the SSA will reach a determination of disabled. Sedentary work requires the ability to lift a maximum of 10 pounds at a time, sit six hours and occasionally walk and stand two hours per eight-hour day.
- Age 50 or older and, due to the post-polio syndrome disability, limited to performing sedentary work but has no work-related skills that allow the person to do so, the SSA will reach a determination of disabled.
- Over age 60 and, due to the post-polio syndrome disability, unable to perform any of the jobs performed in the last 15 years, the SSA will likely reach a determination of disabled.
- Any age and, because of post-polio syndrome, has a psychological impairment that prevents even simple, unskilled work, the SSA will reach a determination of Post-Polio Syndrome disabled.