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Understanding How to Use the Framework of the Medical-Vocational Grid Rules to Win More Cases

It’s important to know a Social Security Disability adjudicator can find the disability claimant is disabled, even if the Medical-Vocational Grid Rules (“Rules”) direct a finding of no disability. This is known as using a “framework” of the Rule—and it’s just as important to understand how it can be applied to the adjudicative process.

In my experience an SSA adjudicator, it is rare to have a fact pattern when a disability claimant has only exertional limitations. Thus, SSA adjudicators can use the Rules as a framework for decision-making at every level of the administrative review. SSA adjudicators can determine the extent to which a nonexertional limitation further diminishes work capacity based on the Grid Rules (see 20 CFR 404.1569a and 416.969a).

Back in 1978, for the sake of efficiency and unity in adjudicating, the Social Security Administration created the Medical-Vocational Grid Rules. The Rules reflect sedentary (201), light (202), medium (203), or heavy (204) exertional levels and major functional and vocational patterns which are encountered in most cases. The Rules also include an analysis of various vocational factors such as age, education, and work experience in combination with the disability claimant’s residual functional capacity. Based on the information, the Rules direct a finding of disability or no disability, while also providing administrative notice that there is a significant number of unskilled jobs (200) throughout the national economy at the various functional levels (sedentary, light, medium, and heavy). Most notably, the administrative notice of these unskilled jobs includes only exertional limitations.

What happens, then, when the disability claimant has nonexertional limitations and the Rule directs a finding of no disability? This is when you can use the framework of the Rule to guide the adjudicative process (and sometimes additional evidence, such as a vocational expert. See 20 CFR 404, Subpart P, Appendix 2).

When a claimant has only nonexertional limitations, Rule 204.00 can be used as a framework in the decision-making. However, it cannot be used to direct a determination—typically, Rule 204.00 applies when a claimant has only mental impairments that significantly reduce his/her ability to perform unskilled work. A claimant can be found disabled under this Rule for functional limitations, such as an inability to follow simple instructions and work with the general public. When using Rule 204.00, you do not need to determine physical limitations if the claimant would be allowed under this rule. Overall, Rule 204.00 indicates nonexertional limitations that significantly erode the unskilled occupational base. If you have a client with such limitations, keep this rule in mind.

Often, a disability claimant’s residual functional capacity or change in age requires applying different exertional levels and/or Rules. In such cases, a framework of the Rules helps resolve these issues. If both Rules direct a finding of disabled, use the framework of the high number Rule to find the claimant disabled (i.e., use 202.06 instead of 201.06). If the Rules direct different decisions due to age or residual functional capacity when you want to find the claimant is disabled, apply the lower numbered Rule (i.e., use 201.14 instead of 201.21). If you want to find the claimant is not disabled, apply the high numbered Rule (i.e., use 201.21 instead of 201.14).

I’ve personally used one Rule for a directed finding and another Rule as a framework for my decisions or argument. It certainly can get confusing and is dependent upon your particular case. Nonetheless, using a framework of a decision resolves issues when two Rules apply to the case. To simplify matters, if your case involves nonexertional functional limitations, use the framework of the Rule(s) to make the decision or create your argument.

Remember, using the Rules at this step in the 5-Step sequential evaluation, it is the SSA adjudicator’s burden of proof to support their decisions that there are other jobs in the national economy that the disability claimant can perform. Additionally, Social Security Rulings provide guidance on specific nonexertional limitations on an individual’s occupational job base.

There is a solution for just about every problem—the next time you’re making a decision or crafting an argument, keep this one in mind.

#SSA #SocialSecurityAdministration #MedicalVocationalGridRules #Adjudicationprocess #SocialSecurityRepresentative

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