Abstract: A man with cerebral palsy and other disabilities recently won an appeal against a disability benefits denial. The panel reviewing his case reminded the SSA to review the specifics of each case and avoid broad generalizations.

A recent case serves as a reminder that a claimant’s real world employability must be taken into consideration as opposed to making a disability determination based on broad generalizations that could lead to a denial of benefits.

More on the case

The case, Igor Zavalin v. Carolyn W. Colvin, involves an immigrant from Russia who arrived in the United States with his family at the age of 13. Zavalin suffered from cerebral palsy along with a learning disability and speech impediment since birth. Although he attended high school in the U.S., his coursework accommodated his disabilities.

On account of his impairments, Zavalin received Supplement Security Income disability benefits through his 18th birthday. However, benefits were discontinued after an administrative law judge (ALJ) reviewed the case and found, based on vocational testimony at an administrative hearing, that Zavalin could complete “simple, routine, or repetitive tasks” such as working as a cashier for a retailer or as a surveillance system monitor.

In order to perform such jobs, though, the worker must have “Level 3 Reasoning” abilities. The ALJ concluded that Zavalin possessed such abilities because he received a high school diploma.

The applicant appealed this finding, arguing that while he received a high school diploma, it was a modified diploma due to his special education curriculum. Thus the appellate panel reviewing the case found that Zavalin lacked the capability to perform the identified occupations and held in favor of the applicant.

Lessons for every disability claim

Every disability claim is unique, and most disputes turn on vocational issues. Just because a claimant for benefits may possess the physical capability to perform a specified job does not automatically mean the claimant has the mental and cognitive abilities to perform such jobs. Both the Social Security Administration and private disability insurers need to engage in a realistic assessment of vocational capability that takes both physical and mental/cognitive limitations into consideration.

Disability claims are complex and often require the assistance of a knowledgeable legal professional to help navigate the claim process. An experienced disability insurance law attorney can assist in working to better ensure a more favorable outcome.

 

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