Thursday, October 17, 2013

A Key Decision on SSA Disability Determination

On June 21, 2013, the Superior Court of New Jersey, Appellate Division affirmed a trial judge’s decision to preclude reference to a Social Security Administration (SSA) disability determination during a personal injury trial.  The decision states, “An SSA disability determination is of dubious probative value in a personal injury action” because:

  • With “due regard for the beneficent purpose of the legislation,” Administrative Law Judges in SSA disability claim hearings are advised to show leniency in establishing the claimant’s disability (whereas a personal injury matter requires the plaintiff to bear the burden of proving his/her disability);
  • The jury could give inappropriate weight to the SSA disability determination, due to the SSA’s being a government agency, despite the questionable efficacy of that determination with respect to causation; and
  • SSA disability determinations are periodically reviewed and subject to overturn, but a jury cannot be asked to reverse its decision years later based on these SSA reviews.
In short, the processes for determining disability for the SSA and in a trial are fundamentally different, and therefore, the conclusions from the former are unreliable in context of the latter.  A key difference is the attribution of disability to a specific accident.  The trial judge responded to the plaintiff’s appeal by aptly noting:

And what this case involves is plaintiff’s claim that she suffered a permanent injury as a result of this accident that resulted in her inability to work.  Those are the issues that this jury needs to determine based on the evidence presented here, not evidence of determination that was made by…[the SSA] that did not have the benefit of the evidence that might have suggested that this disability is not – or was not caused by this accident [emphasis added].

It is important to understand that “disability” can be defined differently depending on the venue in which one finds oneself.  Plaintiff’s counsel in the above matter stated that “the best evidence” that the plaintiff couldn’t go back to work was that the SSA had decided she was disabled; but is the SSA’s process the “best” way to determine disability?  Who can best determine whether an individual is disabled, or unable to engage in any substantial gainful activity due to impairment?  Does the SSA or others determining disability do enough to distinguish between impairment, a medical concept, and disability, a largely psychosocial concept?

For more on this critical distinction, visit our CEU articles on disability vs. impairment.