Getting Disability as a Nurse Who Can No Longer Work

After many years of engaging in strenuous physical activities, it's very common for nurses to experience chronic back and neck pain due to lifting and bending over patients. These injuries can make it impossible for some nurses and nursing assistants to continue working, especially past the age of 50. If you're a nurse or nurse assistant who had to stop working due to illness or injury, you could be eligible for disability benefits from the Social Security Administration (SSA).

What Kinds of Nurses Are Eligible for Disability Benefits?

Anybody who meets the financial eligibility criteria for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) can potentially receive benefits, no matter what their past jobs are. But because your ability to do your past work is a key factor in determining disability, it's important to make sure your nursing jobs are classified properly.

Social Security classifies jobs according to a Department of Labor publication called the Dictionary of Occupational Titles (DOT). The DOT contains descriptions of the physical and mental duties of a particular job. Each job is assigned a specific number—known as the DOT code—that describes the strength and skill levels needed to perform the job's duties.

Nurses tend to go by many different job titles and acronyms, such as registered nurse (RN), advanced practice nurse (APN), nurse practitioner (NP), and certified nursing assistant (CN). These titles don't always directly match a DOT code, so your job might be classified under one of the following codes commonly used for the nursing professions.

Nurse Assistant (DOT Code 355.674-014)

The DOT title of "nurse assistant" can also apply to nurse's aides and certified nursing assistants (CNAs). Most CNA and nurse assistant programs require at least a high school education.

Job Duties:

• care for patients in a hospital, nursing home facility, or similar setting, under the supervision of other medical professionals
• respond to signal lights, bells, or intercom system indicating patients' needs
• bathe, dress, and undress patients
• serve food to patients and help feed patients if required
• transport patients in wheelchairs and assist patients with walking
• prepare patients for exams and treatments
• reposition bedridden patients to prevent bedsores
• change bed sheets, run errands, greet and assist visitors, and answer the telephone
• take and record vital information including temperature, blood pressure, pulse, and respiration rates, and
• cleans, sterilize, and prepare supplies.

Skill Level: Learning how to do all the duties of a nurse assistant requires three to six months of training, giving this position a specific vocational preparation (SVP) number of 4—what Social Security considers semi-skilled work.

Strength Rating: The job of nurse assistant is performed at the medium exertional level, meaning employees must be able to stand and walk for 6 hours out of an 8-hour workday, lift and carry up to 50 pounds occasionally, and lift/carry up to 25 pounds frequently.

Licensed Practical Nurse (LPN) (DOT Code 079.374-014)

The position of LPN typically requires a high school diploma or GED. In some states, such as Texas and California, LPNs may be referred to as LVNs (licensed vocational nurses) or VPNs (vocational practical nurses).

Job Duties:

• treat and care for ill, injured, and disabled individuals in settings including hospitals, clinics, homes, and institutions
• take vital signs, dress wounds, and apply heat or ice to injuries
• administer medication orally or intravenously, noting time and dosage on chart
• collect bodily fluids (including urine, blood, and mucus) for testing and perform routine lab analysis
• sterilize medical equipment
• bathe and dress patients, and
• assist patients with movements such as walking and turning.

Skill Level: With an SVP of 6—requiring one to two years of training—LPN is considered skilled work.

Strength Rating: Licensed practical nurse is a physically demanding position at the medium exertional level, requiring the ability to lift and carry up to 50 pounds occasionally and 25 pounds frequently, as well as stand and walk for 6 hours out of an 8-hour workday.

Head Nurse (DOT Code 075.137-014)

The role of head nurse usually, but not always, requires a bachelor's degree in nursing or a related field.

Job Duties:

• supervise and evaluate nursing personnel in a hospital setting
• visit with patients to make sure nursing care is carried out with competence, and that treatment is administered according to doctors' instructions
• direct the preparation and maintenance of patients' medical records
• inspect hospital rooms for cleanliness and comfort
• accompany doctors on rounds, taking note of special orders regarding patients, and
• provide training for newly hired and veteran nurses.

Skill Level: Head Nurse is a skilled job with an SVP of 6, requiring one to two years of training.

Strength Rating: This position is performed at the medium exertional level, involving lifting and carrying of up to 50 pounds occasionally, 25 pounds frequently, and standing or walking for 6 hours out of an 8-hour workday.

Nurse Practitioner (DOT Code 075.264-010)

Also known as advanced registered practice nurse (ARPN), advanced practice nurse (APN), advanced registered nurse practitioner (ARNP), or a certified nurse practitioner (CNP), this position almost always requires a bachelor's degree and often a master's degree.

Job Duties:

• provide medical care and treatment to patients in a clinic, health center, or similar settings, under a doctor's supervision
• order and interpret diagnostic testing to assess patients' conditions
• consult with doctors and other health professionals to formulate patient care plans
• prescribe or recommend medication or other treatment, such as physical therapy
• may refer patients to physicians or specialists for consultation, and
• may engage in independent practice, if allowed by state law.

Skill Level: With an SVP of 8, nurse practitioner is a highly skilled profession, requiring between four to ten years of training.

Strength Rating: Nurse practitioner is slightly less physically strenuous than other nursing positions, with exertional demands at the light level (involving lifting and carrying up to 20 pounds occasionally and 10 pounds frequently, with standing and walking 6 hours in an 8-hour workday).

Keep in mind that the DOT was last updated in 1991, so the job titles and descriptions don't always reflect the advances in a particular industry. Nursing in particular has seen further specialization since the DOT's last update, and titles such as psychiatric-mental health nurse practitioner (PMHNP) or neonatal nurse practitioner (NNP) aren't described in the DOT. If your job duties aren't adequately covered by a DOT code, make sure you let Social Security know. You can spell out your exact job duties by filling out your work history report (Form SSA-3369-BK).

How Social Security Classifies Your Nursing Work Can Affect Your Chances of Winning Disability Benefits

Disability applicants (whose medical conditions aren't severe enough to meet a listed impairment) need to show that they're not able to perform either their past relevant work or any other jobs that exist in the national economy in order to get benefits. Because you can't get disability if you can do your past work, it's essential that your nursing jobs are assigned the correct DOT code. And for people 50 years of age or older, your job classification can determine whether your skills are transferable to other work—which can make or break your case.

Your Residual Functional Capacity and Your Past Work

Determining what jobs you can do despite your medical impairments is called assessing your residual functional capacity (RFC). Your RFC is a set of restrictions, physical and mental, on what you can do in a work environment. Social Security compares your RFC with the duties, skill level, and strength rating of your nursing position to see if you could still do that job today.

For example, say your physician writes a note stating you can't lift and carry more than 20 pounds—in other words, your doctor gave you an RFC for light work. If the agency says your past job was nurse practitioner—which is considered light work—your disability claim will be denied because Social Security thinks you can still do that job. But if your job is classified as head nurse (medium work) then the physical demands of that job are outside the scope of your RFC, and Social Security won't expect you to return to that job.

If your RFC rules out your past work, Social Security will then consider additional factors such as your age, education, and transferable skills to decide whether you can do other work.

Nursing Jobs and Transferable Skills

Nursing skills are often specifically tailored to the profession of nursing, but some skills can be adapted to other types of jobs. For instance, a head nurse could use their skills as a supervisor to manage a medical records department, and nurse practitioners may use their knowledge interpreting diagnostic tests to help scientific research. Semi-skilled jobs, such as nurse assistant, are less likely to provide transferable skills.

It's usually harder for people who've done highly skilled work to show that they don't have any transferable skills. Knowing how to interpret complex information or use advanced technologies are valuable skills in a wide range of jobs.

But as you approach full retirement age, Social Security has fewer expectations that you can use these skills without making a "significant vocational adjustment." If a vocational expert thinks that you'd need more than just a short time adapting to new tools, processes, or environments before you can use your nursing skills, Social Security might not consider your skills transferable after all.

Ruling Out Other Jobs With RFC Restrictions

If you're younger than 50 years old or you acquired transferable skills from your nursing jobs, you can still get disability benefits if the limitations in your RFC rule out all other work. Examples of such restrictions include:

• being unable to type more than 15 minutes every hour
• requiring extra breaks throughout the workday
• having very limited range of motion in your arms to reach for nearby objects
• needing 20% more time to complete job tasks, and
• missing more days of work than are tolerated by most employers.

For more information on restrictions in your RFC that can get you approved for disability, see our article on physical and mental limitations that prevent all work.

Should I Contact a Disability Attorney?

You're not required to have a lawyer at any stage of the disability process. But an experienced disability attorney can come in handy. Your lawyer can help make sure your nursing job is classified correctly, submit medical evidence showing that you can't do your past work, and cross-examine a vocational expert.