An individual may qualify to receive benefits through the Social Security Disability Insurance (SSDI) program in several ways. One way is to demonstrate that they are suffering from one or more medical impairments identified by the Social Security Administration (SSA) in its official listing of impairments, commonly known as the Blue Book, and that their condition meets the criteria set forth in the particular listed impairment. Even if a claimant cannot point to any of the Blue Book impairments that they either “meet or equal in severity,” the Social Security Administration will undertake the next steps in their sequential evaluation process. Step 4 of the 5 step evaluation process requires the Social Security Administration to determine whether one is capable of performing any of their “past relevant work,” which is defined as any of the past types of work they had performed in the 15 years prior to becoming disabled. If one is determined to be capable of performing their past relevant work, they would be deemed to be not qualified for disability benefits (and would be denied benefits). Assuming, however, the SSA determines one remains incapable of performing their past relevant work, they are required to turn to step 5 of the sequential evaluation process and determine whether the claimant is capable of performing any jobs that exist in the national economy that exist in significant numbers in either their region or other regions of the country. As part of undertaking this analysis, the Social Security Administration will turn to a set of rules called the “SSDI grids” to help them determine in what way one’s age may play a role in making a transfer to other forms of gainful employment unlikely (thereby calling for a finding of disabled under Social Security’s rules). The grids establish guidelines for determining whether a person is disabled based on five factors: age, capacity to work, education, skill level, and transferability of skills.
The Blue Book and the SSDI grids are the two methods used by the SSA to determine whether a claimant meets the “disability” criteria for SSDI eligibility. The two systems are laid out in the SSA’s regulations in Title 20 of the Code of Federal Regulations, in Subpart P of Part 404. Appendix 1 to Subpart P contains the listing of impairments. Appendix 2 describes the grids, formally known as the “Medical-Vocational Guidelines.”
Age Groups
The SSA divides claimants into four age groups for purposes of the SSDI grids:
– Younger individuals: ages 18 to 49;
– Closely approaching advanced age: ages 50 to 54;
– Advanced age: ages 55 to 59; and
– Closely approaching retirement age: ages 60 and up.
Residual Functional Capacity
Based on medical evidence submitted by a claimant, the SSA will do an assessment to determine the claimant’s ability to work on a full-time, ongoing basis, known as residual functional capacity (RFC). This assessment looks at the ability to perform physical tasks, such as sitting, standing, lifting, carrying, pushing, and walking, as well as mental tasks such as “understanding, remembering, and carrying out instructions.”
There are four (4) major categories of RFCs with reference to the exertional requirements of various occupations, these are sedentary, light, medium, heavy, or very heavy work. A claimant who is claiming that they are suffering from a physically disabling severe medical impairment, and whose RFC indicates they are able to perform “heavy” or “very heavy” work, might be less likely to have their claim approved. However, even in a situation where the SSA might conclude that the claimant can do “medium” through “sedentary” work with reference to a younger individual, the Grid rules establish that one’s ability to transfer to other forms of gainful employment (where the claimant is deemed incapable of returning to their former profession) begins to become even more affected once they reach the age of 50 (that is, closely approaching advanced age, and even more affected as they reach advanced age and older). and therefore is not “disabled.” Thus, for example, an individual found incapable of their former employment and found to be limited to performing sedentary or light work, may be deemed more and more incapable of finding other work within these exertional levels unless they have acquired special skills that might allow for a transfer to other skilled work within that exertional RFC level. The grid rules are used for making such analysis.
Education Level
The SSDI grids identify four education levels: illiterate (unable to read, write, or speak English), limited education (no higher than the 11th grade), high school graduate or more (including GEDs), and recent education for a skilled job, provided the claimant has at least a high school diploma or GED.
Skill Level
The SSA assigns claimants to one of three skill levels based on work experience, training, and education: unskilled work (simple tasks, requiring less than one month of training and little judgment while on the job), semi-skilled work (requiring some degree of judgment, attention to detail, or alertness, which usually requires training of up to six months), and skilled work (requiring specific qualifications for a job, as well as individual judgment and specialized knowledge). Training requires six months to multiple years.
A claimant’s description of their work experience forms part of the basis for the SSA’s skill-level decision. It also uses the U.S. Department of Labor’s Specific Vocational Preparation (SVP) rating system, which assigns jobs a number between one and nine based on the amount of training required. A job rated “SVP 1” requires a “short demonstration only,” while a job rated “SVP 9” requires more than 10 years of training.
Transferability of Skills
Finally, the SSA will make a determination as to whether a claimant’s skills are “transferable,” meaning that even if the claimant cannot work in the same job as before, they could use their existing skills in a different job. The more skills a claimant has, the more difficult it will be to establish that they are unable to work in a different field. Providing detailed information about work history and job duties, rather than just a job title, is extremely important.
A claimant’s medical condition can also negate prior skills in some circumstances, such as if a highly educated professional suffers a brain injury and cannot continue working in any related field.
Applying the Grids
Once the SSA has made determinations in the four grid categories, it is simply a matter of finding where the claimant falls on the grids. If the claimant is limited to sedentary work, Table 1 would apply. A “sedentary” claimant who is someone of advanced age (60 or older), has a limited education (no high school diploma), and is deemed to have an“unskilled” work background would be found disabled in accordance with the grid rule .201.01.
Winning SSDI Benefits Despite the Grid Rules
Even if the grids provide that a claimant is not disabled, one may still be able to prevail on their claim. The grids primarily look at a claimant’s ability to do physical work, and therefore they are not always suited to claimants whose impairments are psychiatric, neurological, or otherwise not related to exertion. Some claimants with these types of impairments are not even able to perform sedentary work.
Claimants with more than one impairment may also be able to demonstrate that, despite a relatively high RFC, they cannot transfer skills to a different job.
If a claimant has little education, has only performed “arduous unskilled physical labor” for at least 35 years, and is unable to perform that type of work anymore because of an impairment, they may qualify for disability under the “worn-out worker” rule. This rule also applies to claimants who are at least 55 years old, have limited education and no job skills, and have one or more “severe, medically determinable impairments.”
You can get an analysis of your particular claim and now the Grid rules may or may not be appropriate to your circumstances by scheduling a free consultation with the Law Offices of Russell J. Goldsmith. Call us at 1-800-773-8622 today.
More Blog Posts:
Requesting Reconsideration of an Application for SSDI in Maine and Elsewhere, Social Security Disability Lawyer Blog, August 2, 2015
Lawmakers Must Act to Prevent Depletion of SSDI Trust Fund in 2016, Social Security Disability Lawyer Blog, August 2, 2015
How to Apply for SSDI Benefits in Maine and Beyond, Social Security Disability Lawyer Blog, July 1, 2015