During the duration of a Social Security disability claim the phrase Vocational Factors (VFs) is going to show-up. According to a recent issue paper offered by Social Security, VFs are the applicant’s age, education, and work experience. This article explores the role of VFs in assessing disability benefit claims. In the United States, the Social Security Administration (SSA) uses a five-step process to determine whether an adult qualifies for disabled-worker benefits. This process comprises tests of (1) whether the claimant has current work and income, (2) the severity of the impairment, (3) whether the medical condition meets criteria contained in SSA’s codified Listing of Impairments, and the claimant’s ability to perform (4) past work or (5) any type of work. SSA considers VFs during the last two steps of the process. To varying extents, other countries employ VFs in similar ways. All countries conduct some sort of evaluation of a disability benefit claimant’s residual capacity to engage in paid work, and it is during this evaluation that VFs are most likely to be applied. Although the assessment processes they use may not be as formulaic as SSA’s five-step sequence, other countries generally follow a multistep process to determine program eligibility.
Most Social Security disability hearings will include a vocational expert which the Administrative Law Judge (ALJ) has asked to testify at to provide testimony about the job market, the job qualifications of the applicant and other factors. The conclusion of the issue paper shows that the United States uses different criteria and more heavily relies on the use of VFs than in some other countries.
Conclusion
This comparative survey has shown that the use of VFs in the disability determination process varies widely in OECD countries. Unlike previous surveys, this study focuses specifically on the role played by VFs—age, education, and work experience—in processing disability claims. We also describe the interplay between VFs and functional capacity.
The U.S. disability programs differ from those in other countries in ways besides VF use. For example, most other countries operate sick-leave programs through which the claimant progresses, sometimes in a series of time-limited stages, before application for a long-term disability benefit is permitted. These stages may assign responsibilities to parties besides the claimant, including the employer, the treating physician, and government (or contract) officials. Further, some countries provide partial-disability benefits, for which claim determinations may use VFs to various extents.
The timing with which VFs are used also may differ across countries—perhaps early in the assessment process (for sickness benefits), or later (for long-term disability), or even throughout the entire process, from application to benefit receipt. Mandatory employer participation is common.
In the 11 countries we survey, age and education may not be used as explicit VFs in disability determination processes, but they are used selectively for program eligibility decisions or as mechanisms to restrict or relax eligibility requirements. All of the countries in our survey consider work experience at some point in the disability determination, but they use different methods of assessing how prior work experience or the transferability of skills affects an individual’s eligibility for benefits (or a variety of compensatory services). In fact, individual VFs are rarely considered alone but are generally used in tandem with other factors at different stages in the disability determination processes. For example, VFs may play integral roles in each country’s functional capacity assessments.
To briefly summarize our findings on each VF, we observe that:
- Age is not used in the disability determination processes of most of the countries we survey. The use of age as an explicit factor in determining whether certain claimants are disabled (as in step 5 of the U.S. sequential evaluation process) is rare. However, age is considered in determining eligibility for certain sickness and partial- or long-term disability programs. In general, advancing age is thought to increase the likelihood of disablement, and therefore increase the claimant’s chance to receive a benefit. Sweden uses age in determining program eligibility and Australia uses age in deciding the frequency of reassessment for disability benefit eligibility.
- Education is generally not directly considered during disability determination. The United States is the most notable exception, directly considering education in step 5 of its sequential evaluation process. Likewise, Denmark and the Netherlands consider education in determining the claimant’s ability to perform other work in the general economy. In the same way, formal schooling or training may suggest a claimant’s ability to undertake available vocational or rehabilitative options or employment opportunities.
- Work experience is considered in the disability determination processes in each of the surveyed countries. Work experience is a central factor in assessing a claimant’s transferable skills, which in turn constitute a central component of the RFC assessment that drives many disability assessment procedures.
