7.2 SSA Regulations and Rulings Flashcards
“What is the Code of Federal Regulations (CFR), and how does it apply to SSA programs?”
Answer: “The CFR contains the detailed rules and procedures SSA follows in administering SSDI and SSI programs.”
Explanation: “Part 404 governs SSDI, and Part 416 governs SSI.”
Source: CFR Parts 404 and 416.
“What are Social Security Rulings (SSRs), and how are they used?”
“SSRs are precedential decisions issued by SSA to clarify regulations and policies.”
Explanation: “SSRs help standardize decisions on recurring issues and provide guidance to adjudicators.”
Source: SSA Social Security Rulings (SSRs).
“What is the difference between the CFR and SSRs?”
Answer:
“CFR: Binding federal regulations.”
“SSRs: Interpretations and clarifications that are binding on SSA.”
Explanation: “The CFR provides the legal structure, while SSRs explain how SSA applies these rules in specific situations.”
Case Scenario: Lisa claims her severe anxiety qualifies her for SSDI. Her condition does not meet the criteria in the SSA’s Listings of Impairments, but she argues her limitations prevent her from performing substantial work.
Question: Does SSA regulation allow Lisa to qualify without meeting a Listing?
Answer: Yes, Lisa can qualify if her condition equals the severity of a Listing or prevents her from performing any substantial work.
Legal Explanation: SSA regulations in 20 CFR Part 404, Subpart P outline that claimants can qualify if their impairments equal a Listing’s severity or prevent engagement in Substantial Gainful Activity (SGA).
Key Resource: CFR §404.1520(d) – Determining equivalence to a Listing.
Case Scenario: Mark’s SSDI claim is denied. He appeals, citing an SSA ruling that supports his case. The ALJ claims the ruling is not binding.
Question: Are SSA rulings binding in disability adjudications?
Answer: Yes, SSA rulings are binding on all SSA components, including ALJs, when deciding cases.
Legal Explanation: Social Security Rulings (SSRs) clarify SSA policies and interpretations of law and are binding in administrative proceedings.
Key Resource: 20 CFR §402.35(b)(1) – Binding nature of SSA rulings.
SSA Regulations:
Found in 20 CFR Parts 404 and 416, detailing rules for disability determination.
