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  Disability Payments

email: reimburse@cochlear.org






Since 1995, several regional offices of the Social Security Administration (SSA) have attempted to claim that a profoundly hearing impaired person should no longer qualify for Federal disability payments if they receive a cochlear implant. These include the Knoxville, TN and New York, NY offices.

To date, none have been successful in denying disability payments to cochlear implant users. Hearing officers have consistently ruled that a person with a cochlear implant still meets the requirements for disability under SSA regulations.

Supreme Court Rulings

This debate intensified in June 1999 with two US Supreme Court rulings that narrowed the definition of disability under the Americans with Disabilities Act (ADA).

The position by the Equal Employment Opportunity Commission (EEOC) and US Department of Labor is that whether a person is disabled must be assessed without considering any mitigating measures or corrective medical devices. In fact in a February 1994 ruling (No. 82-OFC-6), the agencies held that a cochlear implant users was still disabled according to the definition used under Section 504 of the Rehabilitation Act of 1973.

However, the 1999 Supreme Court rulings stated that mitigating measures must be considered on a "case by case basis". Many cochlear implant users were alarmed that this ruling might mean their disability payments and Medicaid coverage would be terminated. This is not the case.

The Supreme Court rulings went into some detail to clarify that only persons whose disability was entirely correctable with a particular procedure or device would no longer be defined as disabled.

The Court’s finding was based on cases involving persons whose vision was restored to 20-20 through the use of eyeglasses. The Court specifically stated that its ruling was not intended to apply to every corrective device, and that disability determinations under the ADA were still required to be made on a case-by-case basis. In fact, the Court went so far as to draw specific distinctions between eyeglasses and other devices, noting that a wheelchair hardly makes someone equivalent to a person not disabled.

Cochlear implants are clearly fit closer to the wheelchair example. A cochlear implant does not restore a person’s full auditory function. In fact, the Food and Drug Administration (FDA) approval criteria and National Institutes of Health (NIH) Consensus Conference Statement emphasize that a cochlear implant restores some level of sound sensation that varies widely per patient.

Please click on the following to review each of the Supreme Court’s rulings:


Albertsons, Inc. v. Kirkingburg. No. 98-591
Sutton et al. V. United Air Lines, Inc.. No. 97-1943

Social Security Rulings

Federal SSI disability payments are based upon an individual’s ability to do sustained work-related physical and mental activities in a work setting on a regular, continuing basis. An individual may meet the ADA definition of disability and still be denied disability payments if they can do regular, sustained work. An individual’s residual capacity to do work despite disability is based not on the least amount of work an individual can do, but rather on the most.

Effective July 2, 1996, SSA established criteria specific for hearing impairments. SSR 96-9p acknowledges that extreme degrees of hearing loss may qualify a claimant for disability payments. However, SSA actually claims that hearing impaired persons under age 50 should still be able to perform unskilled work if they retain the ability to hear and understand simple, oral instructions or to communicate simple information.

Obviously, a person with a properly functioning cochlear implant will often meet this minimal threshold of basic communication. This is where the Supreme Court’s wheelchair distinction comes in to play. A person confined to a wheelchair can also perform some of the basic functions set forth in SSA rulings on mobility impairments. Yet the SSA rulings make clear that they qualify for disability payments.

The wheelchair user can navigate in the real world. And the cochlear implant user can communicate in it. However, unlike eyeglasses, neither device removes the daily barriers that would enable them to function "normally."

Studies consistently demonstrate that while post-lingually deafened cochlear implant users may do very well functionally, mean performance tends to be far below what is considered a "normal" adult hearing level. For example, cochlear implant users often can only identify a vowel in isolation 50 percent of the time, and post-operative telephone performance is even further below normal hearing levels. These numbers are dramatically lower for those are pre-lingually deafened.

Cochlear implant performance varies significantly not only among users, but also among settings. In certain workplace situations, especially those involving significant background noise, a cochlear implant user may not be able to engage in basic communication, or respond to environmental sounds warning of injury or death.

Click here for information on obtaining Federal disability payments.