The Medical Vocational Allowance Approval for Social Security Disability and SSI cases

If you have spoken to someone who has applied for disability, or have done some personal research, you may know that applicants can be approved for disability through something known as the Social Security list of impairments. However, this is not the only way. If you file for Social Security Disability or SSI disability, the approval can happen in one of two ways.

Note: the medical vocational allowance approval is how MOST claims are approved so you may wish to skip further down the page. The majority of individuals who have to go to a disability hearing and are granted a disability award are also approved in this way.

Meeting, or equaling, the requirements of a listing

Referred to as the blue book, or simply the listings, the Social Security list of impairments is a collection of medical impairments for which a person may be awarded disability benefits. The listings are divided by body system, such as cardiovascular, respiratory, musculoskeletal, etc, and are further divided into separate listings for adults and children.

Each listing (for example, depression) contains its own separate medical approval criteria. Being approved for disability for a listing is made on the strength of the medical records alone. It does not involve a review of a claimant's vocational work history.

Listing-level approvals are the less common way of being approved for disability benefits. Being awarded benefits on the basis of a listing-level impairment is somewhat difficult because the criteria for most listings is fairly specific; so specific, in fact, that a claimant's medical records will generally not provide the needed information. Added to this, of course, is the fact that many medical conditions are simply not included in the adult and childhood listings.

Disability examiners will typically review a claimant's medical records to determine if they have a listing-level medical condition, either physical or mental in nature. If a listing level condition is not identified (and this is usually the case) the examiner will employ a five step disability decision process known as sequential evaluation, which may result in something known as a medical vocational allowance.

Being approved on the basis of a Medical Vocational Allowance

A medical vocational allowance is granted when Social Security has reviewed both the claimant's medical records and their work history (for the 15 year period prior to becoming disabled) and come to the following conclusions:

1) The individual is not capable of returning to their past work. This includes their last job and potentially any other jobs they may have held in the last 15 years that were worked long enough for them to learn the requirements of the job.

2) The individual is not capable of doing some type of other work based on their job skills, their age, their education level, and their current level of functional capacity (residual functional capacityresidual functional capacity).

Looking for signs of disability in your medical records

Once it becomes clear to a disability examiner that a claimant will not satisfy the requirements of a disability listing, the examiner will review the medical records to look for signs of functional limitations that the claimant has.

These limitations may be physical, such as a reduced ability to walk, stand, or sit for more than a certain period of time. The limitation may be exertional such as a reduction in how much weight the person can lift or carry (Social Security uses classifications of exertional capacity such as sedentary, light, and medium). They may be non-exertional such as a reduced ability to reach overhead, bend at the waist, or bend at the knees. Other examples of physical limitations include a lessended ability to see, hear, speak, feel, or even smell.

Functional limitations may also be mental, such as an impaired ability to remember (there may be impairment in short or long term memory), pay attention, concentrate, learn new information, or interact with other people in a work setting such as supervisors or co-workers.

The limitations that a disability examiner idenfities after reviewing the claimant's medical records will be used to complete an RFC, or residual functional capacity, assessment. This is a precise listing of the individual's limitations (e.g. inability to lift more than 20 lbs occasionally, inability to sit for more than 2 hours, inability to tolerate dust or fumes, inability to maintain concentration).

The RFC assessment is compared to the work demands of the claimant's past work to determine if their current limitations will allow them to go back to one of their past jobs. If their limitations are not greater than what their past work required of them, they will be denied for disability on the basis of being able to return to their past work.

However, if their limitations are severe enough to rule out their ability to return to their past work, the disability examiner will have to determine if the claimant can transition to some form of other work. This decision takes into account the individual's job skills, how old they are, what their functional limitations are, and, to some extent, their level of education.

When a claimant is found to be incapable of doing their past work, and, further, is found incapable of doing other work, they will be approved for disability on the basis of a medical vocational allowance.

How do you improve the chances of getting a medical vocational allowance?

Supply detailed information regarding your medical treatment history so that the disability examiner does not run into difficulty obtaining your records. However, just as importantly, be very sure to include a detailed history of your work for the past 15 years.

Why is this so important? Because the disability examiner who works on your case will use the information you provide to locate your job in a reference source known as the DOT, or dictionary of occupational titles. The DOT lists tens of thousands of jobs, complete with the exertional requirements of each (sedentary, light, medium) as well as the skill levels involved for each job.

Properly identifying your job in the DOT will be heavily dependent on the information you supply regarding your work history at the time you file for disability.

For example, if you work history consists of being a truck driver, you should specify your work requirements and duties when you submit your work history so that, to use an example, you are not classified as a light truck diver when, in fact, you were a heavy truck driver, or a trailer-tractor operator. These jobs come with different exertional requirements and different skill levels which may certainly impact the outcome of your disability case.

It is for this reason that claimants are advised to write down their work history (and their medical history) before their disability application interview is conducted at a Social Security office.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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