As to the remaining 13% of Medicare beneficiaries who qualify on the alternative bases of disability or end-stage renal disease, the standards for establishing disability are essentially the same for Medicare and SSI purposes. Cf. 42 U.S.C. § 423(d) with 42 U.S.C. § 1382c(a)(3)(A); cf. 20 C.F.R. § 404.1505 with 20 C.F.R. §§ 416.

The impairment or impairments must be so severe that the claimant "is not only unable to do [her] previous work but cannot, considering [her] age, education and work experience, engage in any other kind of substantial gainful work which exists in the national economy . " 42 U.S.C. §1382c(a) (3) (B). The Commissioner has promulgated regulations that incorporate a five-step sequential evaluation process for determining whether a claimant is disabled.

For example, whether or not a State recognizes common-law marriage, couples are considered married under the Supplemental Social Security for the Aged, Blind, and Disabled, if “they are found to be holding themselves out to the community in which they reside as husband and wife.” 42 U.S.C. § 1382c(d)(2). Federal immigration law, on the other hand, does not recognize a state marriage if it was entered into for the purposes of procuring an alien’s admission as an immigrant or otherwise evading the immigration laws.