Identification Number:
DI 25025 TN 12
Intended Audience:See Transmittal Sheet
Originating Office:ORDP ODP
Title:Medical-Vocational Guidelines
Type:POMS Full Transmittals
Program:Disability
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM

Part DI – Disability Insurance

Chapter 250 – Medical-Vocational Evaluation

Subchapter 25 – Medical-Vocational Guidelines

Transmittal No. 12, 01/02/2024

Audience

PSC: DE, DEC;
OCO-OEIO: CR, ERE, FDE, RECONE;
OCO-ODO: DE, DEC, DS, RECONE;
ODD-DDS: ADJ, DHU;

Originating Component

ODP

Effective Date

Upon Receipt

Background

ODP is revising DI 25025.030 to clarify policy concerning exceptions to the requirement to cite occupations to support a finding that an individual is “not disabled” under the framework of a medical-vocational rule. We are also fixing broken links and removing gendered language.

Summary of Changes

DI 25025.030 Support for a Framework “Not Disabled” Determination

Citations: We fixed links to several citations, removed a reference to Social Security Ruling (SSR) 86-8, reordered some of the citations to the regulations, and removed the section symbols and some of the other punctuation.

Subsection A: We removed gendered language and language referencing a portion of the Act’s definition of “work which exists in the national economy” (namely, the phrase “either in the region where the claimant lives or in several regions in the country”) that is less relevant to Disability Determination Service (DDS) adjudication. We also revised some of the language to adhere more closely to the regulations, and we moved guidance that previously appeared in B1 to a Note in this subsection. We revised that guidance to clarify it and explain the underlying policy rationale, and we added a reference to DI 25025.005B. We also added guidance indicating that we do not use isolated jobs to support a “not disabled” finding.

Subsection B:

  • We renamed the subsection “Policy for supporting a framework ‘not disabled’ finding,” and we added an introductory sentence clarifying that, except in the situations we describe in Subsection C, DDS adjudicators must document the evidence underlying a framework “not disabled” finding.

  • B1 and B1a:

    • As is noted above, we moved the material formerly in B1 to a Note in Subsection A. A revised version of guidance that previously appeared in Subsection C now appears in B1, whose title has been changed to “Citing occupations.” The revisions to the prior guidance clarify (1) that the cited occupations should be consistent not only with the claimant’s residual functional capacity (RFC) but also with their vocational factors; (2) that we consider citation of three non-isolated occupations to establish that work the claimant can do exists in significant numbers; and (3) that an adjudicator may support a “not disabled” finding by citing fewer than three occupations only when it is clear that jobs exist in significant numbers within those occupations and the adjudicator explains that conclusion in appropriate locations in the Disability Case Processing System.

    • We removed guidance advising adjudicators to base such conclusions on advice from a Vocational Specialist and on information in publications referred to by the regulations, and we added an example illustrating situations in which an adjudicator might appropriately conclude that a significant number of jobs exist in fewer than three occupations.

  • B1b: We removed the remaining guidance that was previously in this subsection, and we moved the material that was previously at C2 into B1b, incorporating minor editorial changes to improve clarity and avoid gendered language.

  • B2: We moved the guidance that was previously in Subsection D into B2, where it appears under a new title (“Citing a Social Security Ruling (SSR)”). We revised the guidance to clarify when it is appropriate to cite SSRs to support a framework determination, and we added an example of a situation in which it would not be appropriate to rely on an SSR to support such a determination.

 

Subsection C: We moved the guidance that was previously in Subsection F to this subsection, shortening the title and clarifying and expanding on the prior guidance (concerning the three exceptions to the rule that non-favorable determinations made under the framework of a medical-vocational rule must cite either occupations or a Social Security Ruling (SSR)). We also added examples illustrating the appropriate use of two of the exceptions.

Subsection D: The content that was previously in Subsection E now appears in this subsection. We moved an excerpt of guidance from SSR 83-14 (regarding a limitation on the ability to feel) so that the guidance now appears in the part of the table that addresses SSR guidance on the vocational significance of manipulative limitations. We added links to SSRs and notes explaining the term “broad world of work,” and we fixed some inaccuracies and formatting errors that previously appeared in the table’s “Issue” column. We moved a parenthetical in Section 4 of the table, and we changed the description of one issue from “Mental” to “Mental demands of unskilled work.” We eliminated a footnote that was previously associated with a discussion of Acquiescence Ruling (AR) 14-1(8), and we incorporated content from that footnote into the body of the discussion of the AR. In the discussion of the AR, we added a link to an SSR and reformatted some of the text to enhance its readability.

Finally, we removed subsections E and F; the guidance that was previously located in those subsections now appears, in revised form, in subsections D and C, respectively.

DI 25025.030 Support for a Framework “Not Disabled” Determination

CITATIONS:

Social Security Act (the Act): 223(d)(2)(A) and 1614(a)(3)(B)
Social Security Rulings (SSR): 96-9p, 85-15, 83-14, 83-12, 83-11, and 83-10
Acquiescence Ruling (AR): 14–01(8)

A. Adjustment to other work with a significant number of jobs

We will make a step five finding of “not disabled” only if we determine that there are a significant number of jobs (in one or more occupations) having requirements the claimant can adjust to given their physical and mental abilities and vocational factors (i.e., age, education, and work experience). In determining whether a “not disabled” finding is supported, we do not consider isolated jobs that exist only in very limited numbers in relatively few locations.

NOTE: When the Medical-Vocational Guidelines direct a “not disabled” determination, the regulations provide the evidentiary support for the “not disabled” finding. For additional information about using the Medical-Vocational Guidelines to direct a determination, see DI 25025.005B.

B. Policy for supporting a framework “not disabled” finding

For a DDS determination with a framework “not disabled” finding, the DDS adjudicator must document the evidence supporting the conclusion that the claimant can adjust to other work, except as explained in DI 25025.030C, in this section.

1. Citing occupations

We support most framework denial determinations by citing occupations the claimant could do given their residual functional capacity (RFC), age, education, and work experience.

a. How many occupations

Cite three occupations. We consider citing three occupations that are not isolated to be sufficient to establish that work exists in significant numbers.

EXCEPTION: You may cite fewer than three occupations ONLY if it is clear that jobs the claimant could do exist in significant numbers within those occupations and you explain how you made this determination in the Vocational Explanation on the Vocational Assessment page in the Claims Analysis section or in a Vocational Analysis (or Vocational Specialist) Case Note in the Disability Case Processing System.

For example, an adjudicator’s ordinary experience may indicate that work as a cashier (Dictionary of Occupational Titles (DOT) code 211.462-010) or as a housekeeping cleaner (DOT code 323.687-014) is so common in the United States that there is little doubt about whether jobs within these occupation exist in significant numbers.

b. Selecting the exertional level of cited occupations

Cited occupations must be within the claimant’s RFC. The claimant may be capable of performing occupations at several exertional levels. For example, we would generally expect a claimant with a medium RFC to be capable of performing medium, light, and sedentary occupations that do not exceed their RFC.

While you may cite occupations from the entire pool of unskilled work that the claimant can perform, citing occupations at the heaviest exertional levels the claimant can tolerate more clearly supports the determination of “not disabled” than does citing occupations from the lighter levels of work. Citing occupations at heavier exertional levels is especially important in denials where, given the claimant’s age, education, and work experience, an RFC for a lighter level of work would be consistent with a medical-vocational allowance.

EXAMPLE: A 55-year-old claimant with a high school education has an RFC for medium work. Although the claimant would have an occupational base of medium, light, and sedentary unskilled work, citing sedentary or light occupations may not support a medical-vocational denial as clearly as citing medium occupations—because an RFC for only light or sedentary work would generally be consistent with a finding of “disabled.”

We base our medical-vocational rules on the existence of unskilled work at all levels of exertion. Rule 204.00 in Appendix 2 addresses a maximum sustained work capability limited to heavy or very heavy work. If a claimant can perform very heavy work, we presume that they would generally be capable of adjusting to work at the heavy, medium, light, and sedentary levels, unless the claimant has additional limiting factors.

NOTE: If the claimant has only nonexertional limitations, their occupational base is for all unskilled occupations, from very heavy down to sedentary. For most claimants with only nonexertional limitations, you may cite some heavy, some very heavy, and some medium unskilled occupations. However, when the claimant is age 60 or above with a marginal education and unskilled work experience, citing sedentary, light, or medium occupations may not support a medical-vocational denial.

2. Citing a Social Security Ruling (SSR)

After you have determined the medical-vocational rule that comes closest to approximating the claimant’s remaining occupational base, you may cite an SSR that supports the use of the rule you are using as a framework for a determination, in lieu of citing occupations. For examples of SSR guidance you may consider citing, see DI 25025.030D, in this section.

  • SSR citation is only appropriate if the cited content of the SSR directly addresses the entire occupational base erosion implicated by the claimant’s RFC. If the claimant’s RFC limitations are not fully considered in the SSR guidance, cite occupations.

  • Cite the framework rule and the SSR that explains why the claimant’s impairment-related limitations do not significantly erode the occupational base represented by the rule you are using as a framework for a determination. Include this information in the rationale for your determination.

EXAMPLE: A claimant with exertional limitations consistent with an RFC for unskilled sedentary work is also limited to frequent fingering and frequent postural activities (climbing, stooping, balancing, kneeling, crouching, and crawling). SSR 96-9p directly addresses the extent to which the claimant’s postural limitations would erode the unskilled sedentary occupational base (see DI 25025.030D3, in this section), but it does not resolve questions about whether the claimant’s fingering limitation would erode the sedentary occupational base. In this case, the adjudicator may not rely on SSR 96-9p to support a framework determination that the claimant is “not disabled,” and the adjudicator must determine whether there are any occupations to which the claimant could adjust.

C. Exceptions to the requirement for supporting citations

Under the following rare exceptions, we do not require citation of an occupation(s) or an SSR because the medical-vocational rules, though used as a framework, provide enough evidentiary support for the “not disabled” finding.

1. Exception 1 – Exertional RFC falls between two “not disabled” rules

  • The RFC for exertion falls between two “not disabled” rules (see DI 25025.015B); and

  • The RFC includes capacity for at least the basic mental demands of unskilled work and no other nonexertional limitation(s).

EXAMPLE: A 45-year-old claimant with a high school education and unskilled past work experience has an RFC for standing or walking 6 hours per 8-hour workday, sitting 6 hours per 8-hour workday, and lifting, carrying, pushing, and pulling 25 pounds occasionally and 15 pounds frequently. The RFC falls between the maximum requirements for medium and light work. Medical-vocational rule 203.28 would apply if the claimant had an RFC for the full range of medium work, and rule 202.20 would apply if the claimant had an RFC for the full range of light work. The directed decision for both rules is “not disabled.” Cite rule 202.20 as a framework for a determination and indicate that Exception 1 applies.

2. Exception 2 – No rule reflects the claimant’s work experience

  • The claimant’s past relevant work (PRW) does not align with the work experience category reflected in any medical-vocational rule that matches the claimant’s age, education, and RFC for exertion (see DI 25025.025C);

  • The RFC for exertion (sedentary, light, or medium exertion) is an exact match with the appropriate rule to use as a framework; and

  • The RFC includes capacity for at least the basic mental demands of unskilled work and no other nonexertional limitation(s).

EXAMPLE: The claimant is 46 years old with a high school education, unskilled PRW and a sedentary RFC. Rule 201.21 is for a younger individual age 45-49 with skilled or semiskilled PRW and no transferable skills. Use rule 201.21 as a framework for a determination, because there is no rule for a 46-year-old claimant with a high school education and unskilled PRW. Indicate that Exception 2 applies.

3. Exception 3 – Transferability of skills would not make a decisional difference

  • You are using the applicable “skills not transferable” rule as a framework because transferability of skills is not material to the determination, as explained in DI 25025.022;

  • The RFC for exertion (sedentary, light, or medium exertion) is an exact match with the framework rule; and

  • The RFC includes capacity for at least the basic mental demands of unskilled work and no other nonexertional limitation(s).

D. Selected SSR citations — the impact of exertional and nonexertional limitations on the unskilled occupational base

1. Standing/Walking

SSR

Issue

Statement from SSR

83-10

Standing/walking—sedentary and light work

“Even though the weight lifted in a particular light job may be very little, a job is in this category when it requires a good deal of walking or standing—the primary difference between sedentary and most light jobs.”

83-10

Standing/walking—light work

“Many unskilled light jobs are performed primarily in one location, with the ability to stand being more critical than the ability to walk.”

96-9p

Standing/walking—sedentary work

“If an individual can stand and walk for a total of slightly less than 2 hours per 8-hour workday, this, by itself, would not cause the occupational base to be significantly eroded.”

96-9p

Alternate sitting and standing

“An individual may need to alternate the required sitting of sedentary work by standing (and, possibly, walking) periodically. Where this need cannot be accommodated by scheduled breaks and a lunch period, the occupational base for a full range of unskilled sedentary work will be eroded.” (This guidance supports the conclusion that if scheduled breaks and a lunch can accommodate the need to alternate positions, the full range of unskilled sedentary work is intact.)

96-9p

Medically required hand-held assistive device—sedentary work

“For example, if a medically required hand-held assistive device is needed only for prolonged ambulation, walking on uneven terrain, or ascending or descending slopes, the unskilled sedentary occupational base will not ordinarily be significantly eroded.” “Since most unskilled sedentary work requires only occasional lifting and carrying of light objects such as ledgers and files and a maximum lifting capacity for only 10 pounds, an individual who uses a medically required hand-held assistive device in one hand may still have the ability to perform the minimal lifting and carrying requirements of many sedentary unskilled occupations with the other hand.”

2. Lifting/carrying/pushing/pulling

SSR

Issue

Statement from SSR

83-10

Lifting/carrying—medium work

“Being able to do frequent lifting or carrying of objects weighing up to 25 pounds is often more critical than being able to lift up to 50 pounds at a time.”

96-9p

Lifting/carrying—sedentary work

“For example, if it can be determined that the individual has an ability to lift or carry slightly less than 10 pounds, with no other limitations or restrictions in the ability to perform the requirements of sedentary work, the unskilled sedentary occupational base would not be significantly eroded.”

96-9p

Pushing/pulling—sedentary work

“Limitations or restrictions on the ability to push or pull will generally have little effect on the unskilled sedentary occupational base.”

3. Postural limitations

SSR

Issue

Statement from SSR

83-10

Stooping—sedentary work

“By its very nature, work performed primarily in a seated position entails no significant stooping.”

83-10

Stooping—light work

“The lifting requirement for the majority of light jobs can be accomplished with occasional, rather than frequent, stooping.”

83-14

Stooping and crouching—light and sedentary work

“However, to perform substantially all of the exertional requirements of most sedentary and light jobs, a person would not need to crouch and would need to stoop only occasionally.”

83-14

Climbing, kneeling, and crawling—medium work

“In jobs at the medium level of exertion, there is more likelihood than in light work that such factors as the ability to ascend or descend ladders and scaffolding, kneel, and crawl will be a part of the work requirement. However, limitations of these activities would not significantly affect the medium occupational base.”

83-14

Climbing, kneeling, and crawling—light work

“On the other hand, there are nonexertional limitations or restrictions which have very little or no effect on the unskilled light occupational base. Examples are inability to ascend or descend scaffolding, poles, and ropes, [and] inability to crawl on hands and knees.”

85-15

Climbing and balancing

“Where a person has some limitation in climbing and balancing and it is the only limitation, it would not ordinarily have a significant impact on the broad world of work.”

NOTE: “Broad world of work” means work that exists at all exertional levels. That work may include skilled and semiskilled work as well as unskilled work. See SSR 83-10.

85-15

Stooping and crouching—sedentary and light work

 

“If a person can stoop occasionally (from very little up to one-third of the time) in order to lift objects, the sedentary and light occupational base is virtually intact.” “This is also true for crouching.”

85-15

Crawling and kneeling

“However, crawling on hands and knees and feet is a relatively rare activity even in arduous work, and limitations on the ability to crawl would be of little significance in the broad world of work.” “This is also true of kneeling.”

NOTE: “Broad world of work” means work that exists at all exertional levels. That work may include skilled and semiskilled work as well as unskilled work. See SSR 83-10.

96-9p

Postural limitations—sedentary work

“Postural limitations or restrictions related to such activities as climbing ladders, ropes, or scaffolds, balancing, kneeling, crouching, or crawling would not usually erode the occupational base for a full range of unskilled sedentary work significantly because those activities are not usually required in sedentary work.”

96-9p

Stooping—sedentary work

“A complete inability to stoop would significantly erode the unskilled sedentary occupational base and a finding that the individual is disabled would usually apply, but restriction to occasional stooping should, by itself, only minimally erode the unskilled occupational base of sedentary work.”

4. Manipulative limitations

SSR

Issue

Statement from SSR

83-10

Reaching, Handling, Fingering—light work

“[Many unskilled light jobs] require use of arms and hands to grasp and to hold and to turn objects, and they generally do not require use of the fingers for fine activities to the extent required in much sedentary work.”

83-10

Reaching, Handling, Fingering—medium and sedentary work

“[In medium work, use] of the arms and hands is necessary to grasp, hold, and turn objects, as opposed to the finer activities in much sedentary work, which require precision use of the fingers as well as use of the hands and arms.”

83-14

Feeling—light work

“On the other hand, there are nonexertional limitations or restrictions which have very little or no effect on the unskilled light occupational base. Examples are … inability to use the fingertips to sense the temperature or texture of an object.”

85-15

Fingering

“As a general rule, limitations of fine manual dexterity have greater adjudicative significance—in terms of relative number of jobs in which the function is required—as the person’s exertional RFC decreases.”

85-15

Feeling

“[Ability] to feel the size, shape[,] temperature, or texture of an object by the fingertips ... is a function required in very few jobs.”

96-9p

Feeling—sedentary work

“The ability to feel the size, shape, temperature, or texture of an object by the fingertips is a function required in very few jobs and impairment of this ability would not, by itself, significantly erode the unskilled sedentary occupational base.”

5. Special senses limitations

SSR

Issue

Statement from SSR

85-15

Vision

“As a general rule, even if a person’s visual impairment(s) were to eliminate all jobs that involve very good vision (such as working with small objects or reading small print), as long as [the person] retains sufficient visual acuity to be able to handle and work with rather large objects (and has the visual fields to avoid ordinary hazards in the workplace), there would be a substantial number of jobs remaining across all exertional levels.”

96-9p

Hearing and speaking

“Basic communication is all that is needed to do unskilled work. The ability to hear and understand simple oral instructions or to communicate simple information is sufficient. If the individual retains these basic communication abilities, the unskilled sedentary occupational base would not be significantly eroded in these areas.”

6. Environmental limitations

SSR

Issue

Statement from SSR

85-15

Hazards

“A person with a seizure disorder who is restricted only from being on unprotected elevations and near dangerous moving machinery is an example of someone whose environmental restriction does not have a significant effect on work that exists at all exertional levels.”

96-9p

Cold, heat, wetness, humidity, vibration, unusual hazards—sedentary work

“In general, few occupations in the unskilled sedentary occupational base require work in environments with extreme cold, extreme heat, wetness, humidity, vibration, or unusual hazards…. Even a need to avoid all exposure to these conditions would not, by itself, result in a significant erosion of the occupational base.”

7. Mental limitations

EXCEPTION: If a claimant with a severe mental impairment resides in Arkansas, Iowa, Minnesota, Missouri, Nebraska, North Dakota, or South Dakota , you may not cite SSR 85-15 in lieu of occupations. For detailed information, see AR 14–01(8) Requiring Vocational Specialist or Vocational Expert Evidence When an Individual Has a Severe Mental Impairment(s).

SSR

Issue

Statement from SSR

85-15

Mental demands of unskilled work

“Where there is no exertional impairment, unskilled jobs at all levels of exertion constitute the potential occupational base for persons who can meet the mental demands of unskilled work. These jobs ordinarily involve dealing primarily with objects, rather than with data or people, and they generally provide substantial vocational opportunity for persons with solely mental impairments who retain the capacity to meet the intellectual and emotional demand of such jobs on a sustained basis.”

 


DI 25025 TN 12 - Medical-Vocational Guidelines - 1/02/2024