Getting Social Security Disability Through a Medical-Vocational Allowance

When you apply for disability benefits, the Social Security Administration (SSA) will first look to see if your medical condition meets or equals the requirements of one of its impairment "listings." A listing is a medical condition that the SSA has concluded is so severe that it warrants automatic approval. If your medical condition meets all the requirements of a listing, you will be approved.

However, most people aren't approved for disability this way. Instead, the majority of applicants will have their claims decided based on whether they qualify for a medical-vocational allowance. Medical-vocational allowances are determined at steps 4 and 5 of the disability determination process, where factors like your employment history and ability to switch to other jobs come into play.

The Medical-Vocational Allowance

To see if you qualify for disability under a medical-vocational allowance, the SSA has to first figure out your residual functional capacity (RFC). The SSA uses your RFC when deciding whether you can do your past job or other work in the national economy. You'll be approved for benefits under a medical-vocational allowance if you can't do either your past work or any other job.

What Is an RFC?

Your RFC describes the most physical and mental activities you can do on a regular and sustained basis. To decide your RFC, the SSA looks at the medical evidence in your file, any notes or records from your doctors, and the results of any consultative examinations. The agency uses this medical information to prepare a detailed assessment of your ability to do certain work-related activities like sitting, standing, walking, lifting, and carrying.

If you have strength-related restrictions from a medical condition that affects your physical functioning, your RFC will contain a restriction to a certain "exertional level." The SSA recognizes five exertional levels, based on how long you can stand, walk, and sit, as well as how much weight you can lift and carry. Based on the agency's review of your medical records and daily activities, the SSA will assign you an RFC for sedentary, light, medium, or heavy work.

The fewer limitations you have in your RFC, the more difficulty you'll have getting approved for benefits. For example, somebody who has an RFC for the full range of medium work will have a tougher time getting disability than somebody who has an RFC for sedentary ("sit-down") work. This is because the higher your exertional level is—meaning you can lift heavier objects, stand longer, and walk farther—the more likely the SSA is going to find that there are jobs out there that you can physically perform.

Your RFC may also contain mental restrictions that reduce the skill level of tasks you can do at work. If you don't have any limitations from a mental illness or cognitive impairment, the SSA will assume that you can perform tasks ranging from simple to complex. But if you have a disorder that makes it difficult for you to focus on a task or side effects from medication that interfere with your memory, your RFC can contain a prohibition against certain types of skilled jobs.

Can You Still Do Your Old Job?

The SSA first looks at the tasks required in your past relevant work to see if you can still do them with your current RFC. If you can still do your past work, you'll be denied right away. But if the SSA decides you don't have the RFC to do your old job, the agency will proceed to the final step of the analysis—deciding whether other jobs exist that you can perform.

For example, say all your past jobs were classified as "light work," meaning you had to stand and walk for up to six hours in an eight hour day and lift ten pounds frequently (and 20 pounds occasionally). If your RFC is for sedentary work (jobs where you need to stand and walk for only two hours in a day and lift no more than 10 pounds), then you can't do your old job, and the SSA will go on to the next step.

However, if your past work was as an administrative assistant (typically a sedentary job) and the SSA concludes you still have the RFC for sedentary work, your application will be denied—unless you can prove that you have other functional limitations that keep you from doing your past work. For example, symptoms from carpal tunnel syndrome may make it too painful to type at the level required for the administrative assistant position, or you may have a severe anxiety disorder that prevents you from interacting with people on a regular basis.

Are There Any Other Jobs You Can Do?

If you can't do your old job, the SSA has to decide if any other jobs exist that you can do in the national economy. If there is work in significant numbers that you can still perform despite the limitations in your RFC, your application will be denied, and if no other work exists that you can do, your application will be approved. At this stage, your past work experience becomes especially important, because the SSA will look at it to see if you learned any skills at your past work that could be transferred to a new job.

For most disability applicants under the age of 50, showing that you can't do any work available nationally means being unable to perform even simple, sit-down jobs. In Social Security lingo, this is called "having an RFC for less-than-sedentary work." Here's an example of how the SSA can award benefits based on an RFC of "less than sedentary."

An RFC that allows for sit-down work is one of the most common reasons why younger disability applicants are denied benefits. But some applicants 50 years of age or older can qualify for benefits even if they're physically capable of performing seated jobs under a special set of circumstances known as "the grid rules."

The Grids

If you're at least 50 years old, the SSA will use what disability lawyers call "the grids" to decide whether you can receive a medical-vocational allowance. The grids are a series of tables that determine when applicants are disabled based on their RFC, age, education level, skill level of their past work, and whether they acquired any "transferable skills" in their old jobs. Here is an example of how the SSA might use the grids to decide a claim.

Even if the grids don't state that someone in your situation is disabled—perhaps because you have transferable skills, or are younger than 50—you can still qualify for benefits if limitations in your RFC rule out all jobs. For example, the grids don't take into consideration important restrictions on "non-exertional" activities, such as poor memory and concentration, difficulty getting along with others, or trouble using your hands and fingers.

Note that there is one situation where the grid rules can help you win your claim if you're younger than 50—if you're between the ages of 45 to 49, illiterate, and have an RFC for sedentary work, grid rule 201.17 directs an automatic finding of disability.

Tips for Getting a Medical-Vocational Allowance

Most people who are ultimately awarded benefits are found disabled by way of a medical-vocational allowance—but they're typically denied benefits at least once before getting approved. You can improve your chances of winning at an earlier stage of the disability determination process by following a few key tips:

• Provide the SSA with as much accurate information about your past jobs as you can. This will help the agency classify your past work correctly, instead of spending a lot of time figuring out what exactly you did.
• Make sure you give the SSA all of your relevant medical information as early in the application process as possible.
• Keep the SSA up to date with any new information about your health conditions. This includes imaging (such as X-rays), changes in medication, or seeing a new doctor.
• Ask your doctor to fill out an RFC form for you.

If you're initially denied, don't be too discouraged. According to SSA statistics, most disability applicants are denied at least once. However, you may wish to consider hiring an experienced disability attorney to help with your application. Your lawyer will be able to tell you which (if any) grid rules apply to you, evaluate the strengths and weaknesses of your case, and help you gather enough medical evidence to support a disabling RFC.