SSR 96-1p: Clarifies that Social Security will follow their own interpretation of their agency policy even when a federal circuit court decision conflicts with that interpretation, unless they issue an Acquiescence Ruling (AR).
SSR 96-2p: Clarifies that medical source statements from a person’s treating doctor (MD, DO or licensed psychologist) are entitled to special significance. In fact, opinions from treating sources (MD, DO or licensed psychologist) regarding the nature and severity of their patient’s impairments and what the person can still do despite their impairments are entitled to “controlling weight” if they are well supported by medically acceptable clinical and laboratory diagnostic techniques and are not inconsistent with other substantial evidence in the record. Claimant should always solicit opinions from medical treating doctors.
SSR 96-3p: In determining at step 2 of the sequential disability analysis whether or not a person’s impairment(s) is “severe”, adjudicators follow a two-step process. First, they must determine whether there is objective medical evidence of an impairment that is likely to produce the pain and other symptoms alleged. If so, then the second step is to determine the duration, intensity and functionally limiting effects of the symptoms along with the objective medical evidence and all the other evidence in the file.
SSR 96-4p: In determining the effect of symptoms on a person’s ability to do work-like activities, adjudicators must first determine that there is a medically determinable impairment(s) likely to produce the pain or other symptoms alleged. Then, the adjudicator must consider the functionally limiting effects of these symptoms. Restrictions are classified as “exertional” or “exertional.” Exertional limitations are those that restrict a person’s ability to do any of the seven strength demands of a job; i.e. sitting, walking, standing, lifting, carrying, pushing and pulling. All other limitations are classified as “nonexertional.” These can be things such as postural limitations (restrictions of the ability to stoop, bend, crouch, crawl, kneel, etc.), manipulative limitations (restrictions on fingering, handling, reaching, etc.), or mental limitations, among others. If a person’s limitations fit squarely within one of the Medical/Vocational Guidelines (or Grids) then that particular Grid rule determines a decision of “disabled” or “not disabled.” The Grids are tables set forth using the work categories of sedentary, light, medium, heavy, and very heavy. They also take into consideration a person’s age, education and prior work experience (skilled v. unskilled). If a person’s limitations do not fit precisely within one of the Grid rules, then the Grids do not direct a result but are used as a framework for decision making. In cases where there are solely nonexertional limitations, the Grids do not direct a result but are used as a framework for decision making.
SSR 96-5p: Certain issues are reserved for the Commissioner of Social Security (of necessity acting through agents such as Administrative Law Judges, or ALJs). These are: whether or not a person is “disabled”, whether or not a person’s impairments meet or equal in severity one of Social Security’s listings, what a person’s residual functional capacity is (or remaining ability to do work-like activities despite their medical impairments), whether or not the person’s RFC prevents him or her from doing prior relevant work (substantial work done in the past fifteen years prior to adjudication), and how the vocational factors of age, education, and prior work experience apply. Medical opinions on these issues are not entitled to any special significance (because these issues are controlling as to an ultimate decision and the adjudicator cannot abdicate the responsibility to make these decisions), but they cannot be ignored.
SSR 96-6p: At the initial and reconsideration levels of adjudication in disability cases state agency medical and psychological consultants are adjudicators (or decision makers). At the hearing level of adjudication (a person can request a hearing if their claim is denied at the initial and reconsideration levels), the opinions of state agency medical and psychological consultants are not binding. The Administrative Law Judge (ALJ) must make a new and independent decision based on all the evidence in the file. This is called a decision de novo. The opinions of state agency medical and psychological consultants, although not binding, cannot be ignored.
SSR 96-7p: In cases where a favorable decision cannot be made on objective medical evidence alone, the claimant’s statements as to his or her own symptoms and their functionally limiting effects take on great significance. In this respect, adjudicators must consider a claimant’s credibility applying various factors. So, moral of the story is: as a claimant, it is important to not exaggerate symptoms and to not minimize symptoms.
SSR 96-8p: Residual functional capacity (RFC), or a person’s remaining ability to do work like activities despite his or her medical impairment(s), is typically one of the most important issues in a disability case if a favorable decision cannot be made on the medical evidence alone. It comes into play at steps four and five of the five-step sequential analysis for determining disability. It is defined as the most a person can do despite his or her impairments. It is further defined in terms of the most a person can do on a regular and continuing basis, which means eight hours a day five days a week or an equivalent work schedule. If a person’s RFC would limit them from maintaining full-time work, a decision of “disabled” is made. The regular and continuing basis definition is a very important one to focus on from the perspective of disability claimants.
SSR 96-9p: Sometimes a person will be found to have an RFC that is “less than sedentary.” This means that the person, given his or her limitations caused by medical impairments, cannot do a full range of sedentary work as defined in the Dictionary of Occupational Titles, or DOT. A full range of sedentary work is defined as the ability to sit for six out of eight hours, stand and walk for two out of eight hours, lift a maximum of 10 lbs. , and lift and carry small items throughout the day, such as ledgers, docket files and small tools. An RFC of “less than sedentary” signifies very serious limitations; however, it does not automatically mean a decision of “disabled” must be made. Oftentimes, the person’s limitations must be compared against jobs that exist in the national economy to determine whether there are significant numbers of jobs the person can still do despite his or her very serious limitations. Social Security has a limited burden of proof at the final step of the five-step disability evaluation analysis, to show that there are such jobs and to provide examples of them. This is why there is almost always a vocational witness at disability hearings. An RFC of “less than sedentary” becomes especially critical for younger workers applying for disability benefits. Younger workers are defined as under age 50 (except in cases where the concept of borderline age applies). This is because special rules apply for workers over age 50, which often allow a decision of “disabled” where the person retains the ability to do the full range of sedentary work, but who cannot do any of their prior relevant work. Older individuals (over 50 years of age) are presumed to have an adverse vocational profile that makes adjustment to other work more difficult.