Solely Nonexertional Impairments
A summary of SSR 85-15
When evaluating a disability case, social security must determine if a person who has medically determinable severe impairments meets or equals the criteria in one of the listing impairments. I have previously posted on meeting or equaling a listing impairment on August 28th, 2014. I have posted on the listings of impairments on June 9, 2014. These are impairments with specific, carefully defined medical criteria that are published by social security and updated from time to time, which presumably prevent gainful employment.
If the person’s severe impairments do not meet or equal one of the listings, but do prevent the person from doing the work they have done in the past fifteen years, then the adjudicator must determine if the person can adjust to other work. This involves a determination of the person’s residual functional capacity (RFC), age, education and work experience. I have posted on residual functional capacity on March 20, 2014. Basically, it refers to the most a person can do despite their medical limitations; i.e., stand for six out of eight hours, or lift no more than 10 lbs. occasionally, etc.
Social security categorizes limitations as exertional or nonexertional. Exertional limitations are those that limit a person’s ability to meet the strength demands of a job. These strength demands fall into the seven basic categories of sitting, standing, walking, lifting, carrying, pushing and pulling. All other limitations are characterized as nonexertional impairments.
Nonexertional impairments affect activities such as the ability to reach; to seize, hold, grasp or turn an object (to handle); to bend the spine alone (stoop); to bend both the legs and spine (crouch); to bend the legs alone (kneel); to pick or pinch (finger); to see, speak and hear; to communicate; to tolerate environmental conditions (such as exposure to excessive dust or fumes if a person has a respiratory condition); and to handle the mental and emotional demands of a job.
The way social security evaluates solely nonexertional impairments is set forth at SSR (Social Security Ruling) 85-15. I have posted on SSRs on April 16, 2014. They give guidance on how to evaluate disability cases and are binding upon the Social Security Administration.
The occupational base for a person with solely nonexertional impairments typically cuts across the full range of exertional work categories, from sedentary to light to medium to heavy to very heavy. I have posted on April 4th, 2014 on how Social Security categorizes different types of jobs according to their strength demands – ranging from sedentary all the way up to very heavy.
Social Security also categorizes jobs according to their skill level. These are the basic categories of unskilled, semi-skilled and skilled work. The occupational base for a person with solely nonexertional impairments will also include jobs above the unskilled level if the person has skills that are transferable to skilled and semi-skilled occupations that fit with their RFC.
Social Security will consider a person’s vocational factors of age, education and work experience along with the nature and severity of their impairments in determining disability. For example, a person might be considered to have adverse vocational factors if they are older, have limited education, and/or limited work experience.
The first issue in determining disability for a person with solely nonexertional impairments is how much the person’s occupational base is reduced by the effects of the impairments. This may range from very little to very much, depending upon the individual circumstances. In making this determination, the adjudicator will often need to consult a vocational resource or vocational specialist. I have posted on the use of vocational experts at social security hearings on March 11, 2014.
The second issue is whether the person with solely nonexertional impairments can make an adjustment to other work. In making this determination, the interaction of their remaining occupational base with their age, education and work experience must be considered. So, for example, a person with a large occupational base might ordinarily be found “not disabled” absent strong adversities in the areas of age, education and work experience. On the other hand, a person with a very limited occupational base might be found “disabled” even if he or she has vocational factors that might ordinarily be considered favorable (i.e., a relatively young age, university education, and highly skilled work experience).
With respect to mental impairments, a careful consideration of RFC is important. Just because a person with a severe impairment does not meet or equal a listing does not mean the inquiry stops there. The adjudicator must go on to consider what effect the person’s limitations would have on their ability to sustain full-time employment.
If, for example, the person’s mental impairments prevent them from meeting the demands of their prior work and prevent the transferability of acquired work skills, then the issue is whether or not the person can perform unskilled work. The basic mental demands of competitive work, even at the unskilled level, include the ability to understand, remember and carry out simple instructions; to respond appropriately to supervision, co workers and usual work situations; and to deal with changes in a routine work setting. A substantial loss of the ability to do these basic work activities might justify a finding of “disabled” even for a person with a fairly favorable vocational profile.
Unskilled jobs ordinarily involve dealing primarily with objects rather than with data or people. These kinds of jobs generally provide substantial vocational opportunity for persons with mental impairments that are still able to meet the mental and emotional demands of the job on a sustained basis. But persons with adversities of age, education or work experience may still be found disabled with the large occupational job base.
An example that is given in the SSR is a cafeteria worker who is closely approaching retirement age, has limited education or less, and has worked in a cafeteria in an unskilled job as a “server” dealing almost constantly with the public. The person can now no longer deal with the public on a frequent basis because of mental limitations. Because of the narrowed vocational opportunity for such a person because of their age, education, lack of skills and long commitment to a particular type of work, a finding of disabled would be appropriate. However, such a finding might not be appropriate for a younger, better educated, or skilled worker.
It is well known that almost any job involves a certain amount of stress. The reaction of a person with mental illnesses to the stress demands of a job is highly individualized and variable. A person with a severe mental disorder may find supervision intolerable. A careful, individualized determination must be made of the person’s RFC.
Limitations in climbing and balancing, if those are the only limitations, would not ordinarily have a significant impact on the broad world of work, although some occupations may be ruled out that required climbing ladders and scaffolding (a construction painter or a firefighter, for example).
Stooping (bending the body downward and forward by bending the spine at the waist) is required in almost any kind of a job. Thus, inability to stoop at all would presumably substantially narrow the occupational base. If a person can stoop occasionally (from very little up to one-third of the time), the ability to do sedentary or light work would not be seriously compromised, although medium or greater work might be prevented. The same would be true for crouching (bending the body downward and forward by bending both the legs and spine).
Crawling on hands and feet is a relatively rare activity and limitations on crawling would not have much effect on the person’s ability to engage in the wide world of work. The same would be true of kneeling (bending the legs at the knee to come to rest on one or both knees).
Reaching, handling, fingering, and feeling are progressively finer ways to use the upper extremities to do work-like activity. Reaching is extending the arms and hands in any direction. Handling involves seizing, holding, grasping, turning or working primarily with the whole hand or hands. Fingering involves finer movements and may include picking or pinching or otherwise working primarily with the fingers. Fingering is needed to do most unskilled sedentary jobs. Generally, the more limited the person is in terms of meeting the strength demands of jobs, the greater the significance of their manipulative limitations.
With respect to hearing impairments, the more severe the impact on ability to communicate, the greater will be the erosion of the ability to do a wide range of work.
With respect to visual impairments, even these were to eliminate all jobs that require very good vision (such as working with small objects), if the person has the visual acuity to work with rather large objects and has the visual fields to avoid ordinary hazards in the workplace, there would still be a substantial number of jobs available at all exertional levels. But a favorable finding of disability might be appropriate in limited instances such as where the person has an extremely adverse vocational profile, e.g. closely approaching retirement age, limited education or less, unskilled or no transferable skills, and essentially a lifelong commitment to an occupation in which good vision is essential.
With respect to environmental limitations, if the person is medically restricted from being around excessive dust, fumes, noise, et., the impact on the broad world of work would be minimal because most work environments do not involve great amounts of noise, dust, fumes, etc. A person with a seizure disorder whose only limitation is to avoid unprotected heights or dangerous machinery would still have substantial vocational opportunities. On the other hand, a person who can tolerate very little dust, noise, etc. might have very limited vocational opportunities because very few job environments are entirely free of dust, contaminants, irritants, pollutants and other potentially damaging conditions.
I realize this has been a lengthy summary and kudos to anyone who has had the patience to read the entire post. Despite its length, I would still call it a summary because the ruling itself is about ten pages long and covers a lot of ground.
To sum it up concisely, each case is highly individualized and fact intensive where only nonexertional impairments are involved. There is no cookie-cutter approach or one-size-fits all approach. The adjudicator must consider all of the evidence to determine the person’s limitations and their effect on the person’s ability to engage in the wide world of work.
This material should not be construed as legal advice for any particular fact situation, but is intended for general informational purposes only. For advice specific to any individual situation, an experienced attorney should be contacted.
When it comes the family law and social security disability, each client and case is different. It is also important to select an attorney with the experience, skills and professionalism required to address your legal issues. To learn more, contact the Salt Lake City law offices of Melvin A. Cook and schedule an initial consultation to discuss your case.