The “worn out worker” rule, a little-known provision of the Social Security regulations, applies to some disability applicants whose employment history consists of many years of unskilled physical labor. The worn out worker rule allows for eligible disability claimants who would otherwise have their disability claim denied to be awarded Social Security benefits.
The worn out worker rule is established under the Code of Federal Regulations (20 C.F.R. § § 404.1562, 416.962). This federal law sets forth that a Social Security disability applicant who meets certain conditions will have his or her disability application approved. To qualify, the disability applicant must:
Before deciding whether or not the worn out worker rule applies to a disability applicant, the Social Security claims adjudicator (claims examiner or administrative law judge) will first evaluate the applicant's disability status using Social Security's five-step evaluation process. If the disability claimant isn't found disabled under these any of the steps, then the claims examiner or administrative law judge should consider the worn out worker rule.
Many of the Social Security applicants who could qualify for disability benefits under the worn out worker rule are actually approved because they meet the requirements for disability under a medical listing or residual functional capacity (RFC) assessment. In that case, the claims examiner or judge never considers the work out worker rule.
Under the regular rules, to be approved for Social Security disability after an RFC assessment, you must prove that you are unable to perform any type of work on a consistent basis. If an applicant can't do his or her past job, but can do other, lighter work, such as an unskilled job that requires monitoring a computer, the applicant would likely be found not disabled. However, using worn out worker rule results in finding of “disabled” for some applicants who would otherwise be considered able to perform lighter work.
Although the worn out worker rule is relatively straightforward, it's not always applied when appropriate. Relatively few disability applicants qualify under the rule, and thus, some claims adjudicators may not recognize it when the file for an applicant who does qualify crosses their desk.
Even when the rule is considered, errors can be made in the evaluation process: a mistake can be made when determining if an applicant is eligible under the worn out worker rule. For example, the claims examiner may mistakenly believe that an applicant's education was not marginal or that an applicant's work was not arduous and unskilled.
Whether or not you qualify for benefits under the worn out worker rule, Social Security law, and the requirements to qualify for disability benefits are specific and complex. Hiring a qualified disability lawyer will ensure that your file is being evaluated appropriately.