If you're a nurse or nursing assistant who was forced to stop working due to illness or injury, you could be eligible for Social Security disability benefits. After many years of nursing, it's common for RNs, LPNs, LVNs, and CNAs to suffer from chronic back and neck injuries due to manually lifting and bending over patients. These injuries often make it impossible for some nurses and nursing assistants to continue working past age 50 or 55.
In deciding whether a disability applicant can work, the Social Security Administration (SSA) takes into account a number of factors, including age, education, medical situation, and the mental and physical demands of the applicant's past jobs.
In classifying your past work, Social Security uses the Dictionary of Occupational Titles (DOT), a Department of Labor volume updated most recently in 1991. Because the DOT is considered out-of-date by most labor market experts, it's important to be aware of how the DOT classifies your past jobs, and, if necessary, to demonstrate where your past work as you actually performed it differs from the job as described in the DOT.
While the DOT contains many different listings for nurses, in truth the profession has seen even further specialization since the DOT's last update. Designations such as Advanced Practice Registered Nurse (APRN), psychiatric-mental health nurse practitioner (PMHNP), or neonatal nurse practitioner (NNP) don't exist in the DOT. Thus, if your job contains duties other than those described in the relevant DOT, make sure you and your lawyer provide this information to Social Security.
Here are a few of the most commonly used listings in the DOT for occupations in the nursing field. Each occupation listed in the DOT contains a job description, Specific Vocational Preparation (or SVP, which denotes skill level), and strength rating. We'll discuss the importance of these numbers below.
Skill Level: SVP 6 (considered skilled work, requiring one to two years of training)
Strength Rating: Medium (requiring all-day standing, occasional lifting of up to 50 pounds and frequent lifting of up to 25 pounds)
Note that in some states, such as Texas and California, LPNs are generally referred to as LVNs (licensed vocational nurses) or VPNs (vocational practical nurses).
Skill Level: SVP 4 (semi-skilled work requiring three to six months of training)
Strength Rating: Medium
Note that the DOT title "nurse assistant" can also apply to nurse's aides and nursing assistants, and certified nursing assistants (CNAs).
Skill Level: SVP 6
Strength Rating: Medium
Skill Level: SVP 8 (highly skilled, requiring four to ten years training)
Strength Rating: Light (requiring standing from six to eight hours per day, lifting 20 pounds occasionally and ten pounds frequently)
For the vast majority of disability applicants whose conditions aren't severe enough to meet a Blue Book listing, Social Security may award benefits based on the Medical-Vocational Guidelines (the "Grid Rules") or based on Residual Functional Capacity (RFC). The Grid Rules, in recognizing that older individuals with few skills and/or little education are often unemployable, provide for an automatic award of benefits to certain individuals based on the combination of their age, education, work experience, and RFC. For instance, the Grids dictate that a 55-year-old with a tenth-grade education, unskilled work history, and sedentary RFC is automatically disabled, even if he or she might technically be able to perform certain sit-down jobs. In contrast, a 55-year-old with job skills that could be used at a different type of job won't be considered disabled, even with an RFC that's limited to sedentary work.
In many cases, the grid analysis hinges on whether a disability applicant gained skills from past employment that would transfer to other jobs. Nursing skills are often particular to the profession of nursing, but some skills can be adapted to other types of jobs. For instance, head nurses could use supervisory skills in various manager positions, and nurse practitioners could use their knowledge to teach nursing students. In general, it's difficult for disability applicants with semi-skilled or skilled work histories and transferable skills to be found disabled based on the Grid Rules. However, Social Security has issued guidance stating that while LPNs and other nurses sometimes possess transferable skills, nursing assistants or nurse's aides rarely do.
However, even if you come from a skilled nursing job, it's still possible to be approved for disability benefits if your RFC (the most you can do despite your medical condition) contains a limitation that would prevent all work. For example, if you needed to lie down for at least two hours during the workday, Social Security would find you disabled since you couldn't work as a nurse or hold any other job.