Getting Social Security Disability Based on a Medical-Vocational Allowance

When the Social Security Administration (SSA) 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 for the SSA to award them benefits automatically, a method known as meeting a listed impairment. But having the medical requirements necessary to "meet a listing" is difficult.

Instead, most applicants who receive benefits were able to show that limitations from their health keep them from working full-time. The SSA refers to benefits awarded this way as a "medical-vocational allowance" because it takes into consideration what types of work activities you're unable to perform, unlike meeting a listing (which is based solely on your medical records).

What Is the Process of Getting Disability Based on a Medical-Vocational Allowance?

If Social Security determines that none of the conditions you have meet a listing, the agency will review your medical records in order to determine what functional limitations you have. 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.

The SSA will then take your functional limitations and translate 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 reflect 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.

What Restrictions in Your RFC Determine Whether You Get a Medical-Vocational Allowance?

Social Security doesn't expect you to work in a situation that's too painful, or too stressful, for you to handle, so the agency will look at all your impairments combined to determine your RFC. Your RFC will likely include a bundle of restrictions about the kinds of activities you should avoid at work. Restrictions can be classified as exertional, non-exertional, and mental.

Exertional Restrictions

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 most length of time you can be on your feet, is called your exertional level.

• A restriction to a sedentary exertional level means that you're limited to sit-down jobs where you don't need to lift more than 10 pounds maximum.
• A restriction to a light exertional level means that you can stand and walk for 6 hours out of an 8-hour workday but can't lift more than 20 pounds maximum.
• A restriction to a medium exertional level means that you can stand and walk for 6 hours per workday but can't lift more than 50 pounds maximum.

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.

Non-Exertional Restrictions

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 slipped disc in your lower back, 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.

• The ability to perform an activity constantly means you can do jobs requiring that activity up to 100% of the day.
• The ability to perform an activity frequently means you can do jobs requiring that activity up to two-thirds of the day.
• The ability to perform an activity occasionally means you can do jobs requiring that activity up to one-third of the day.

Just like with your exertional level, limits in your RFC on the amount of non-exertional activities you can perform depends 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.

Mental Restrictions

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.

• If you can perform skilled work, you can follow complex instructions and think abstractly.
• If you can perform semi-skilled work, you can follow detailed, but not complex, instructions.
• If you can perform unskilled work, you can follow simple, one- to three-step instructions.

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.

How Your RFC Determines Whether You Can Qualify for a Medical-Vocational Allowance

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 (your "past relevant work") 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, the SSA 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."

Getting a Medical-Vocational Allowance Based on 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 the types of job skills they have (if any). Here are some examples of how the grid rules work.

• If your RFC says you can do only sedentary work, but you are 55 or older, 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.
• If you're 50 to 54 years old and limited to sedentary work, and you have job skills (or a recent education) that you can use for some type of sit-down work, you'll be expected to use your knowledge at a new, sedentary job. But if you don't have any recent training or job skills that could be transferred to a sit-down job, you'll be found disabled.
• If you're older than 55, your RFC says you can do light work, and you don't have "transferable skills," the SSA doesn't expect you to be able to learn a new job, and you should be awarded benefits under a medical-vocational allowance. In most other cases, if you can do light work, the SSA will expect that you can learn a new job.
• If you're younger than 50 and have an RFC for sedentary work, you'll only be found disabled according to the grid rules if you've never worked and can't read or write.

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.

Getting a Medical-Vocational Allowance by Ruling Out All Available Jobs

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.

For more information, see our other articles on how Social Security decides whether you're disabled.