Good morning and welcome to the third hearing in our series on securing the future of the Social Security Disability Insurance program.  Today we will focus on how disability is decided.  

For more than 50 years the Social Security Disability Insurance program has provided a vital safety net for workers who have worked long and recently enough and who meet the definition of disability.  

When Congress created the disability insurance program in 1956, it defined disability as the inability of an individual to work due to a physical or mental impairment.  Qualified impairments are those that are expected to last for no less than one year or those expected to result in death.

Over the years, Social Security has created complex criteria and a time-consuming process that is frustrating to claimants, costly to the taxpayer, and frequently raises questions about the consistency, accuracy, and fairness of this program.

Our witnesses today will tell us how claimants apply for disability and how the State Disability Determination agencies, which are fully funded by Social Security, decide eligibility.  

As we will hear today, deciding whether someone is eligible for benefits is far from easy.  Examiners, supported by medical consultants, must analyze medical and other evidence and take a series of complicated steps to make their decisions.  

In the 1980’s Congress also created requirements relating to the opinion of treating doctors and how pain and other symptoms affect the ability of an individual to work.  A morass of policies — developed to help ensure consistency and respond to court decisions — have also added to the complexity of this program.  

It’s no surprise then that there are wide variations in outcomes, raising questions about whether this program is being administered consistently across the country and whether claimants are being treated fairly.  

Further, Social Security has had an uphill climb for years to provide the kind of policy oversight, quality review, and ongoing training that massive disability workloads require.  It has also struggled to stay current with needed updates to the list of medical conditions considered severe enough to qualify for benefits.  

While this program has served as a vital safety net to millions of Americans, the reality is that much has changed since 1956.   Thanks to advances in medical care many people with disabilities experience greater independence and as a result can live more productive lives.

Legal and social changes have promoted participation by people with disabilities into mainstream society.  And the nature of work has changed significantly as we have moved from an economy largely defined by manual labor to a service and knowledge-based economy.  

Yet the all or nothing standard of half a century ago is often criticized as a work disincentive, furthering dependence by those who might otherwise be able to achieve varying levels of self-support.  

As we consider securing the future of this program, we owe it to the American public to ensure that this program effectively serves the interests of applicants, beneficiaries and taxpayers.