Rules surrounding presidential succession have never been entirely clear or straightforward. The original framers of the Constitution spent relatively little time on this issue and were heavily influenced by the existing state constitutions on gubernatorial provisions in designing their language on executive succession. The original Constitution signed in 1787 did not contain a succession clause. It took until 1790 to obtain the necessary thirteen state approvals for Article II, Section 1, Clause 6, to be ratified:

This section of the Constitution does not discuss the vice president taking over the president's job in full, but rather as serving temporarily until the president recovers or a presidential election is held. Note also that disability, or what should be considered to constitute disability, is not defined. Further, this paragraph conflates permanent kinds of disability, such as death and resignation, with potentially temporary forms of “inability.”

One of the delegates from Delaware, John Dickinson, asked at the time: “What is meant by the term disability and who shall be the judge of it?