Showing posts with label acronyms. Show all posts
Showing posts with label acronyms. Show all posts

Saturday, December 12, 2009

SGA


Every time I hold a Social Security hearing I briefly reflect on the value of work for pay in our society. Indeed, as I tell every claimant, the point of the hearing is for me to determine, using Social Security's rules, whether it is reasonable to expect that they have the capacity to work for pay. This presupposes that everyone ordinarily has the basic capacity for remunerative work. It also presupposes that a person can lose the functional capacity to work. In essence, a Social Security Law Judge is a person who is supposed to be able to tell the difference.


The unquestioned assumption here is that everyone can and should work if they are able. I suspect this assumption has always existed in human society. The unique feature of the modern era is the role of money in defining the worth of work. The birth of the very idea of work for wages is detailed in Adam Smith's The Wealth of Nations (1776). Karl Marx brilliantly expounds the social cost of wage labor in his giant Capital (1867). The spiritual heritage of wage earning is detailed in The Protestant Ethic and the Spirit of Capitalism (1904) by Max Weber. These three classics form the basis of my understanding of why people work for pay, the social tension created by inequalities of wages and the process through which commonplace wage earning is infused with meaning.


Social Security law is not concerned with such details. There is no mention of meaningful work in the regulations. There is little notice taken of the soul crushing effects of lifelong poverty. For Social Security the inquiry starts and stops with a simple question: can this person be expected to earn enough through work to constitute substantial gainful activity? As of 1/1/10 the regulations define substantial gainful activity [SGA] as the ability to earn $1000 per month from work of any kind. At the minimum wage of $7.25 a person has to work just 32 hours a week to reach this level. We're not talking deeply satisfying work here, we're talking basic survival.


As I rolled these thoughts around in my mind the last few weeks, I occupied my lunch half-hour sitting at my desk reading The Pleasures and Sorrows of Work (2009) by British essayist Alain de Botton. As a rule I dislike books that have a lot of illustrations, but the numerous candid black & white photographs by Richard Baker of people working are wonderful. I also really like the fact that the book closely examines various types of work. De Botton chooses warehouse logistics with an emphasis on tuna fish, cookie making, career counseling, satellite launching, oil painting, electrical transmission engineering, accountancy, entrepreneurship and aviation sales. He seems to see himself as a sort of Michael Moore figure padding around in these various venues asking probing questions of unsuspecting and generally cooperative informants. It's clear that independently wealthy de Botton has scant respect for his subjects. His greatest praise is for the middle aged slightly successful artist who obsessively paints the same tree year after year. His greatest scorn is for the workers in complex enterprises: office workers, factory managers, vocational experts, scientists, engineers, sales representatives and wide-eyed inventors. He sees all of them as mildly desperate souls trying to distract themselves from their own inevitable mortality. Judging from this book de Botton most admires the stoic philosophers.


Nonetheless this is an interesting book. While de Botton is too assured of his own intellectual superiority to be a person I'd ever like to meet, he asks good questions and does succeed in opening up his subjects in a way I've never seen before. His curiosity about the ordinary and commonplace reveals whole new worlds. I never knew there was a society devoted to admiring and visiting the various types of electricity transmission pylons. I had no vision of how the French launch satellites in the jungle of Guiana. The cut-throat competition between biscuit makers was unknown to me before reading this book. I often had to keep pushing through the author's stilted prose and arch commentary to reach his really interesting insights. It was worth it, even though it was often discouraging. I'm not the only one to feel this way about this book as can be seen from the NY Times Book Review from last summer: http://www.nytimes.com/2009/06/28/books/review/Crain-t.html?pagewanted=1&_r=1


It took me about a month of lunches to finish the book in small bites. The exercise left me more deeply appreciative of the value of wage earning. We spend much of our waking hours doing something to earn wages. We usually endow this work with meaning beyond the instrumental value of the money it produces. People are proud of their work and happy when they do it well. This psychic value helps us get up and go to work every day, not just pull the covers up and go back to sleep. If work somehow loses this meaning, people will stop doing it. If a physical or mental injury is severe enough to overpower the meaning of a person's work, the person becomes disabled.

Saturday, October 24, 2009

ADLs


I ask the claimant to describe an average day in his or her life in almost every hearing. In Social Security speak these questions about activities of daily living are called ADLs, of course. The point of this exercise is to get a better idea of the sorts of things a person can actually still do despite their disabling condition. Allowing for some inevitable exaggeration, this enquiry is often very enlightening.


I generally ask people to account for the 12 – 15 hours they are awake each day. What do they do for fun? What are their hobbies? Do they take care of any animals? A shockingly large number of people tell me they do nothing but doze in their recliner or watch TV all day. I've written about this before here: http://edpitts.blogspot.com/search/label/TV Still, at this point in the hearing many people relax somewhat and tell me things that really help me evaluate their case.


A person who lives on a small farm tells me about taking care of her goats.


A person tells me about how he doesn't throw a ball inside for his Chihuahua anymore after that time it broke its leg. “That was expensive.”


One person tells me about scrap booking; another about using the computer to make a family tree.


I ask everyone if they socialize at all. Even if they tell me they don't, I ask more probing questions. Do they ever visit with family members? How far away do they live? How do they get there? Do they go to church or AA meetings? How do they get to their doctor's appointments?


Recently I talked to an older guy who lived just outside of a rural town, who had worked as a janitor at a nursing home for quite a few years. He told me he never socialized with anyone, but he was a talkative and friendly sort of guy.


“Don't you ever go down to the Huddle House for a cup of coffee with your friends?”


“No Judge, I don't.” “Why's that?”


“Well Judge, I've got a little touch of homophobia, I think you call it.”


I heard a sharp intake of breath from Jane, the hearing monitor sitting next to me.


There was a 10 second pause as I tried to imagine what was he talking about. The possibilities seemed endless. I briefly tried to imagine that he might think the guys who hang out drinking coffee all day are gay – Nope, probably not.


The only thing to do was ask.


“What do you mean, how does that keep you from going for a cup of coffee?”


“See, I don't go to restaurants at all. I don't like to eat after anybody, like at a buffet or smorgasbord. I can't stand to use the same serving spoon as everybody else. I won't even eat off the same dishes as my wife.”


“Are there other things you are nervous about?” “Yeah, you know, like I can't stand it if my wife leaves even the smallest crumb on the kitchen counter. I've got to clean it up, or I can't do anything else. Or like one time at work one day a patient dropped a glass and I spent all morning cleaning up every little piece, then got real upset when someone found another tiny sliver.”


“Did you ever tell these things to your doctor?” “I think so.”


“Well sir, you seem to be describing something called Obsessive-Compulsive Disorder, or OCD.”


“Oh, right, I think my doc did say something about OCD.”


“A little OCD may not be a bad thing for a janitor, but if it's keeping you from seeing your friends you might want to talk to your doctor some more about it.”


“OK, judge.”