In evaluating a claim for disability, the Social Security Administration (SSA) will consider how your exertional and non-exertional limitations affect your ability to work. To do this, the agency will prepare a residual functional capacity assessment (RFC). An RFC is a detailed report that discusses how your impairments impact your ability to perform certain work-related activities; it establishes the most you can do in light of your impairment.
Combination of Exertional and Non-Exertional Limitations
Many disability claimants (applicants) have several impairments that prevent them from being able to work. These impairments can cause both "exertional" and "non-exertional" limitations.
An exertional limitation is one that affects your ability to do the physical demands of a job, and most are strength-related. Exertional limitations affect your ability to any of the following seven tasks:
- push, and
The SSA uses your exertional limitations to categorize your RFC into one of the following work levels:
- sedentary work
- light work
- medium work
- heavy work, or
- very heavy work.
For instance, if your doctor says you can't carry more than 10 pounds on a regular basis, and you can never lift more than 20 pounds, the SSA will give you an RFC for light work. (And if you can do light work, you can do sedentary work.)
Your claim will usually be denied if the SSA finds that your RFC allows you to do a job in any of the above categories, assuming that the job exists in significant numbers in the local area or United States, and that one of the "grid rules" for older people doesn't apply to your situation (see our article on the medical-vocational grid rules). That said, the SSA must also seriously consider your non-exertional impairments when deciding if you are disabled.
Non-exertional limitations are functional limitations that affect your ability to do non-strength-related work activities. They include all physical limitations except for the seven exertional restrictions listed above, as well as mental limitations. Examples of non-exertional limitations include difficulty doing the following tasks:
- using fingers and hands to manipulate, reach, or handle objects (manipulative restrictions)
- stooping, climbing, crawling, or crouching (postural restrictions)
- seeing, speaking or hearing (visual and communicative restrictions)
- functioning because of nervousness, anxiety, or depression
- paying attention or concentrating
- understanding or remembering detailed instructions, and
- being around noise and dust or in hot or cold temperature extremes (environmental restrictions).
Non-exertional limitations can be caused by symptoms such as pain or can result from mental illness such as anxiety or depression.
If your non-exertional limitations are related to your mental health, the SSA will prepare a mental RFC. If your non-exertional limitations are caused by a physical impairment, they will be discussed in your physical RFC. Remember, however, that the SSA will only use symptoms that are documented in your medical records, so make sure you have provided them with all your medical evidence.
Non-Exertional and Exertional Limitations
If a claimant has both exertional and non-exertional limitations, the SSA must use the RFC to consider the combined effect of your limitations to determine if a claimant is disabled. Note that pain can affect capacity to do either exertional or non-exertional work. For instance, chronic, intense pain in the low back can affect one's ability to lift, bend, and concentrate.
How the SSA Combines Exertional and Non-Exertional Impairments
Sometimes the SSA will find that a claimant has the physical RFC to perform some level of work, but when the SSA considers a claimant’s non-exertional limitations, the agency concludes that the claimant cannot perform the non-strength-related requirements of the work. This should result in an approval of benefits. Here are examples of how combining exertional and non-exertional limitations can result in an approval of a claim.
In one case, a claimant suffered from back pain. He also had severe carpal tunnel syndrome in both of his hands and wrists that prevented him from fully using his hands and fingers. He had undergone surgery for his carpal tunnel but it was not successful. The claimant’s past work had been as a machinist. After considering the medical evidence related to the claimant's back pain, the SSA concluded that, although he couldn't do his old medium-work job, he still had the physical RFC to perform sedentary work. Normally, this conclusion would result in a denial. However, sedentary jobs require a person to be able to use both hands. The inability to finger and feel (use your hands and fingers effectively) is a non-exertional impairment; therefore, when the SSA considered the combined effect of his exertional and non-exertional limitations (limited to sedentary work but unable to use his hands and fingers effectively), the claimant was approved for disability.
In another case, a 52-year old claimant suffered from lower back pain and bi-polar disorder. Based on her physical limitations alone, the SSA determined she had the RFC to perform light jobs. However, the medical evidence also demonstrated that the claimant suffered significant difficulty with memory and concentration because of her mental illness. The SSA and the claimant’s doctor prepared mental RFCs based on this evidence. The SSA concluded that in light of the extent of her non-exertional impairments, the claimant would be unable to meet the mental requirements of even unskilled work, and she was approved.
How Non-Exertional Limitations Can Help Your Case
To assess whether you can do your past work, your attorney can require the SSA to do a "function-by-function" analysis comparing the limitations in your RFC with the requirements of your prior jobs. If any of your non-exertional limitations aren't consistent with your prior work (either as you performed it or as the work is generally performed), the SSA must find that you can't return to your prior work.
When the SSA looks at whether there are less demanding jobs that you can perform, having non-exertional restrictions can rule out some of the jobs at your RFC level. For example, there are many jobs available for those who are limited to sedentary work, but having non-exertional limitations can make the pool of suitable sedentary jobs much smaller. (See our articles on being able to do only a limited range of work, and note that a grid rule that says you are "not disabled" doesn't apply if your non-exertional limitations restrict you from doing a full range of work at your RFC level.) If the pool of jobs that are within your restrictions are too small, Social Security will grant you disability benefits via a "medical-vocational allowance."
If you are at the hearing level, a vocational expert (VE) will use your RFC to testify as to what jobs you can still do. (See our article on VE testimony.) A disability attorney can argue that your non-exertional limitations rule out various jobs within an RFC level (that is, light or sedentary). If your non-exertional limitations rule out many jobs, it is said that they "erode the occupational base" for that level of work. For instance, if you are able to sit most of the day and can walk and stand occasionally, but you can't use your fingers to handle and manipulate objects, that would rule out most types of sedentary work. For more information on how to rule out jobs, see our articles on proving you can't do your past work and showing you can't do "other" work.
How Your Doctor Can Help
Doctors who work for the SSA prepare your physical and/or mental RFCs, but you should ask your doctor to fill out a physical and/or mental RFC form for you as well. Claims examiners at the SSA have to give substantial weight to your treating doctor's opinion on what your limitations are. But if they don't have a detailed statement of what your doctor thinks your limitations are, they make their best guess from your medical records. Here is an RFC form you can give to your doctor.
Getting Help When You Have Multiple Impairments
Using the combination of both exertional and non-exertional impairments to win a claim is difficult; however, it is a useful and frequently successful approach when done right. You should contact an experienced disability attorney to discuss whether your exertional and non-exertional impairments could help you win your claim. You can find an attorney in your area by contacting a disability lawyer here.