How to Get Disability Benefits Based on a Medical-Vocational Allowance

If the Social Security Administration (SSA) finds that you don’t meet its severity requirements for a particular disability (that is, you may have a severe impairment, but it doesn’t match an official SSA impairment listing), before rejecting your application for disability benefits, the SSA is required to look at your condition further. The SSA is required to consider the effect of your impairment on your capacity to perform daily activities and to function at work. After determining what your remaining capabilities are, if the SSA determines there is no work you can be expected to do, given your age, education, and skills, you will be granted disability benefits via a “medical-vocational allowance.”

Matching an Impairment Listing vs. Medical-Vocational Allowance

Most applicants for disability benefits do not match one of the SSA’s listed impairments in the SSA’s “blue book,” which lists specific, severe criteria for illnesses. For instance, to qualify for disability based on blindness, you must have worse than 20/200 corrected vision in the better eye; to qualify for disability based on asthma, you must have severe asthma attacks requiring physician intervention at least once every 2 months, despite being on prescribed treatment.

In fact, most applicants who are granted benefits are approved through a medical-vocational allowance.

How Functional Limitations Affect the Disability Determination

After a disability claims examiner at DDS (Disability Determination Services, a state agency that works for the SSA) determines that your condition doesn’t match a blue book impairment listing, the claims examiner will send your file to a medical consultant at DDS (a doctor, psychiatrist, or psychologist). The medical consultant will perform an RFC (residual functional capacity) assessment on your claim. That is, the consultant will evaluate your medical record, your doctor’s notes, and the results of laboratory or clinical tests to determine how much functional ability you have remaining, after considering the effects of your impairments. In particular, the consultant will look for notes from your treating doctor on the functional limitations and restrictions your medical problems cause you, to determine if your problems rise to the level of a disability that prevents you from working.

For instance, if you have poor eyesight, your doctor’s notes may show that you have been advised not to drive. If you have a herniated disc, your doctor may have restricted you to lifting under 20 pounds. These are common functional restrictions, or limitations. (Unfortunately, many doctors neglect to put functional limitations into medical records, which can really hurt a patient's chance of getting disability benefits.)

Residual Functional Capacity (RFC) Assessment

The medical consultant will use your functional restrictions or limitations to rate your ability to work. To do this, the consultant will use an RFC form to come up with a residual functional capacity level for you. The RFC level determines whether you can do sedentary work, light work, medium work, or heavy work. For instance, if your doctor has limited your standing and walking to no more than five hours per day, your RFC will be for sedentary work. If your doctor has limited you to no lifting more than 20 pounds, but doesn’t limit your standing or walking, your RFC will be for light work. If you can carry up to 50 pounds for up to one-third of the day, and up to 25 pounds for up to two-thirds of a day, your RFC will be for medium work. For more information, see our article on the RFC assessment.

Do You Qualify for a Medical-Vocational Allowance?

Next, the DDS consultant will look to see if, given your RFC, you should be able to do any jobs that you’ve done in the past 15 years. If you are assigned an RFC for light or medium work and you have always done heavy work, the consultant will find that you can’t go back to your past work.

Then, the consultant will look to see whether, given your RFC, along with your age, education, and skills, there is any other work you can be expected to do. For example, if you worked for a moving company, but you were given an RFC for medium work, it’s likely the SSA will find that there are many sedentary and light jobs you can do. However, there are some cases in which the consultant isn’t allowed to “send” you to other work. For example, if you are older than 55, have less than a 6^th grade education, and don’t have transferable skills, the SSA doesn't expect you to be able to learn a new job. In this case, you should be granted disability benefits under a medical-vocational allowance. In most other cases, if you can do medium work, the SSA will presume that you can learn a new job.

Vocational Rules Grid

The SSA has a grid that sets out the vocational rules that determine whether a claimant will receive a medical-vocational allowance. These vocational rules take into account a person's RFC, age, the types of job skills they have, and their education level. For instance, if you can do only sedentary work, but you are 55, never graduated high school, and worked heavy jobs all your life, the grid rules say you are disabled and should be approved for benefits through a medical-vocational allowance.

On the other hand, if you are limited to sedentary work, you are 30 years old, and you have a college education or transferable skills, the grid rules say you are not disabled, and the SSA will deny you benefits. To see the grid of vocational rules, as well as explanations of the vocational rules, see Nolo’s Guide to Social Security Disability, by David Morton. 

To learn more, see How Social Security Decides if You are Disabled.