When Social Security is determining whether you’re disabled, the agency needs to consider two important factors: how limited you are because of your health condition (the medical factor), and whether your condition prevents you from doing any jobs (the vocational factor). Some disability applicants are able to prove that their health is poor enough to qualify for disability based solely on the medical factor, a method known as “meeting a listed impairment.”
Having the medical requirements necessary to “meet a listing” is difficult, however. Most applicants who receive benefits do so by getting a “medical-vocational allowance.” Social Security awards medical-vocational allowances to people who don’t meet the strict requirements of a medical listing, but nonetheless aren’t able to work. Because medical-vocational allowances are the most common way of getting disability, it helps to know how the agency arrives at them.
If the Social Security Administration (SSA) doesn’t think that any of your medical conditions meet a listing, the agency will review your records for evidence of functional limitations you have that could limit the types of jobs you can do. Functional limitations are problems that you have doing any activities, such as basic movements or tasks, because of your physical or mental impairments. Being unable to pull on a sweater because you have a torn rotator cuff or struggling to complete a puzzle due to ADHD are examples of functional limitations.
Social Security takes your functional limitations and translates them into terms an employer (or vocational expert) would understand in a process called assessing your residual functional capacity (RFC). Your RFC is a set of restrictions that reflects the most you’re capable of doing in a work environment. For example, somebody with a torn rotator cuff might be restricted from jobs involving overhead reaching, while someone with ADHD could be limited to simple, repetitive, routine job tasks.
Social Security doesn’t expect you to work in a situation that’s too painful or too stressful for you to handle, and your RFC should reflect this. The agency looks at your combined impairments to determine your RFC, which will likely include a bundle of restrictions about the kinds of activities you should avoid at work. These restrictions can be classified as exertional or non-exertional. (Mental impairments fall under the category of nonexertional impairments.)
Applicants with physical conditions will almost always have an RFC that limits them from performing jobs requiring heavy lifting or lengthy standing. The maximum amount of weight that you can lift and carry, as well as the maximum length of time you can be on your feet, is called your “exertional level.”
The exertional level your RFC contains depends on the severity of your physical symptoms. Somebody with an MRI showing mild-to-moderate arthritis in their neck might have an RFC restricting them to light or medium work, while someone with an MRI showing severe arthritis could be restricted to sedentary work.
Physical restrictions that aren’t about how much weight you can carry but still affect the kinds of jobs you can do are called “non-exertional” restrictions. If you have difficulty tying your shoes because you have a bulging disc in your lower back, for example, your RFC will likely limit the amount of bending you can do (a postural restriction). Or if you have carpal tunnel syndrome that makes it hard for you to type, your RFC will include how long you can use your hands (a manipulative restriction).
Restrictions on non-exertional activities are defined by how often you can do them in an 8-hour workday.
Just like with your exertional level, the limitations in your RFC on the amount of non-exertional activities you can perform depend on how severe your symptoms are. Somebody with mild asthma might still be able to work around dust or fumes (an environmental restriction) frequently, while somebody with moderate asthma might only be able to tolerate that occasionally. If your symptoms are severe enough, your RFC might contain restrictions preventing you from doing an activity at all.
If you have a mental health condition, you experience side effects from medications that impair your memory and concentration, or you struggle to focus through pain, your RFC will contain restrictions on the types of job tasks you can do and who you can work with. Job tasks are classified according to skill level, which reflects how challenging they are.
Additional mental restrictions in your RFC might include limitations on how often you can work with co-workers, supervisors, or the general public. As with non-exertional restrictions, you may be limited to constant, frequent, occasional, or zero contact with others on the job, depending on how severe your mental symptoms are.
Once Social Security has taken all your limitations into account and arrived at your RFC, the agency will review your work history (going back five years) to see if your RFC prevents you from doing any of the jobs you’ve done before. For example, if you worked in a warehouse where you had to lift over 50 pounds, and your current RFC says you can’t lift more than 10 pounds, Social Security will find that you can’t perform your past work.
If your RFC rules out returning to your past jobs, then Social Security needs to determine whether other, less demanding work exists that you can do (or easily learn to do). Applicants over the age of 50 who can’t perform their past work might have an easier time getting a medical-vocational allowance under a special set of circumstances called the “grid rules.”
Social Security acknowledges that as people near retirement age, learning new job skills or switching career paths becomes more difficult. So for applicants 50 years of age and older, the SSA has a grid that sets out the rules that determine whether they will receive a medical-vocational allowance. The grid rules take into account applicants’ RFC, age, education, and any transferable skills they have. Here are some examples of how the grid rules work.
To see the full grid of vocational rules, as well as explanations of the vocational rules, see our section on Social Security's grid rules by age.
Not everybody over the age of 50 (nor the majority of people under the age of 50) will be able to use the grid rules to get a medical-vocational allowance. If your medical limitations and vocational profile—age, skills, and education—aren’t covered by the grid rules, you’ll need to show that no jobs exist in the national economy that you can do despite your restrictions.
While it’s more difficult to prove that you can’t perform any jobs—even the easiest, least stressful ones—it’s not impossible. Many non-exertional and mental limitations can, when taken together, add up to a finding that you’re unable to perform what Social Security calls “sustaining competitive employment.” Missing too many workdays or having reduced productivity because of your health conditions can mean that no employer is willing to hire you full-time, resulting in a medical-vocational allowance.
Social Security doesn't calculate the amount of your award based on how you were found disabled, so it won’t matter whether you were approved using a medical-vocational allowance or by meeting a listing. Instead, the amount of your monthly payment will depend on whether you're eligible for the Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) program. You can find out how much each benefit pays in our article on SSDI and SSI monthly check amounts.
Most people who apply for disability benefits don’t get approved on their first try. If, after reading over the denial letter, you disagree with the SSA’s decision, you have 60 days to submit an appeal. Social Security’s appeals process typically involves getting another denial before you can request a hearing with an administrative law judge.
You aren’t required to have an attorney to appeal a denial, but it’s usually a good idea. An experienced disability lawyer or advocate can help you gather the proper medical paperwork, make sure you don’t miss important deadlines, and represent you at a disability hearing. And because disability lawyers aren’t allowed to charge you if you don't win—and they’re limited to a small percentage of your disability backpay if you do win—there’s little risk in finding a lawyer near you to help with your claim.