What are the Medical-Vocational Grid Rules (“the Grid”)? Another blog article on this site describes the five step sequential evaluation process disability claims adjudicators and administrative law judges (“ALJs”) employ in order to decide disability claims before them. Because the Grid rules apply at the last step of the sequential evaluation process, that article, entitled The Five Step Sequential Evaluation Process, should be reviewed prior to reading this entry.
The Grid is a pre-determined table that is also used by claims adjudicators and ALJs at the last step of the sequential evaluation process when the legal question becomes whether or not the claimant can perform any other work in the national economy. Therefore the Grid is only used if the claimant is not engaged in substantial gainful activity, if they have a severe impairment established by objective medical evidence that does not meet or equal a listing and if they cannot perform their past relevant work.
For those under 50 (sometimes 49 ½) years old the Grid almost always results in a denial of a disability claim. However for those over 50 years of age, depending on the occupations that they have held over the last 15 years (their past relevant work – “PRW”) and their education level the Grid can sometimes require that claims adjudicators and ALJs approve a claim for disability benefits.
Essentially, as a claimant gets older the Grid rules somewhat relax what a claimant needs to prove in order to get approved for disability benefits. There are four main categories, younger individuals – which is defined as an individual 45-49 years of age, those closely approaching advanced age – defined as an individual 50-54 years of age, those of advanced age – defined as individuals 55-59 years of age, and those closely approaching retirement age – defined as those over 60 years of age.
Every claimant will be assigned a residual functional capacity (“RFC”), which is the most that they are able to physically do in a work setting in spite of their impairment(s). If a claimant’s RFC does not allow them to do their PRW then the Grid is often used to decide their disability claim. For younger individuals and those closely approaching advanced age (ages 50 to 54) at least a sedentary RFC is required.
For claimants of advanced age (ages 55-59) at least a light residual functional capacity is usually required.
For claimants closely approaching retirement age (60 years or older) at least a light RFC is again required but additional vocational requirements are used when looking at transferable skills. Also taken into consideration by the Grid rules are a claimant’s education, any language barriers they may have, as well as the skill level of any of their PRW.
The easiest way to describe how the Grid rules work would be to provide some examples (and again remember that the Grid only applies at the last step of the sequential evaluation process):
1) Claimant A is a 47 year old individual who has always worked in manual labor, occasionally lifting 50-100 lbs. and lifting 25-50 lbs. frequently as well as being required to stand at least 6 hours in an 8 hour work day and typically perform other physical requirements such as bend, stoop, crawl, climb etc…which is defined as a heavy occupation. Claimant A’s RFC has been set at sedentary due to his severe impairment(s). Unless claimant A is illiterate and/or unable to communicate in English claimant A’s claim will be denied by the Grid rules. Essentially it will be determined that he can adjust to work at the sedentary occupational base of work.
2) Claimant B is a 52 year old individual who also has only done manual labor as his PRW. His RFC has been determined to be sedentary. Claimant B has graduated high school and also has a year of technical schooling, both completed many years ago. In this case Claimant B would be approved because manual labor is typically considered an unskilled occupation and he would not have any transferrable skills to other work. At his age, even if he is able to do sedentary work, he is deemed unemployable due to the negative age factor.
3) Let us stay with the previous hypothetical for the next example. Changing claimant B’s PRW to rough carpentry let us assume that rough carpentry has the same physical demands as manual labor and is not an unskilled occupation but rather a semi-skilled occupation. Whether or not claimant B under these facts would be approved or not would depend on whether or not PRW as a rough carpenter would have any transferrable skills to a sedentary occupation. If rough carpentry is an unskilled occupation then there are no transferrable skills to other work and this claim would be approved.
4) Claimant C is a 55 year old individual who also has done manual labor as his PRW. His RFC however has not been limited to sedentary work but rather to light work, a more physically demanding occupational base. Claimant C has a high school education which he obtained many years ago. Because manual labor is defined as a heavy occupation and his high school degree was obtained a long time ago this claimant cannot adjust to work at the light occupational base and would or should be approved.
As you can see the Medical-Vocational Grid rules can be complicated but to summarize briefly, depending on a claimant’s age, past relevant work history, their education level and whether or not they have any transferrable skills to perform other work a claimant may have an easier time being approved for disability benefits than a younger individual with the exact same disabilities and work history. A Hoglund disability attorney can describe this to you in more detail.
The five step sequential evaluation process is the five step legal analysis applied by both the Disability Determination Service (DDS) at the first two levels of a disability claim, application and then reconsideration if denied, and by an Administrative Law Judge (ALJ) at the third level of a disability claim if both the initial application and reconsideration have resulted in denials. It is simply a legal framework that ensures that all disability claims are treated the same.
The major requirements of sedentary work are lifting up to 10 lbs. occasionally and negligible weight frequently and sitting 6 hours in an 8 hour work day.
The major requirements of light work are lifting up to 20 lbs. occasionally and up to 10 lbs. frequently as well as being able to stand at least 6 hours in an 8 hour work day.