Effective Dates: 03/06/2024 - Present Previous | Next

TN 14 (03-24)

DI 25025.001 The Medical-Vocational Guidelines

CITATIONS:

Social Security Act (the Act) §§: 223(d)(2)(A) and 1614(a)(3)(B)
20 CFR §§: Part 404, Subpart P, Appendix 2, 404.1520(f), 404.1560 thru 404.1569(a), 416.920(f), and 416.960 thru 416.969(a)
Social Security Rulings (SSR): 85-15, 83-14, 83-12, 83-11, and 83-10

A. History and purpose of the medical-vocational guidelines

In 1979, we published the medical-vocational guidelines in Appendix 2 to Subpart P of the regulations. The purpose of the medical-vocational guidelines is to increase the consistency of disability determinations and decisions at step 5 of sequential evaluation.

B. Description of the medical-vocational guidelines

The medical-vocational guidelines consist of one numbered rule, 204.00, and three tables of numbered rules, Table No. 1, Table No. 2, and Table No. 3. We also call the tables “the grids.” Each numbered rule in the tables of the appendix resolves the issue of ability to adjust to other work by addressing specific combinations of residual functional capacity (RFC), age, education, and past work experience. These medical-vocational rules in Tables No. 1, 2, and 3 indicate the resolution of the issue of ability to adjust to other work in the “Decision” column for the rule. Rule 204.00 provides guidance on ability to adjust to other work.

1. Rule 204.00

a. Whom do we evaluate under rule 204.00 of the medical-vocational guidelines?

We use rule 204.00 for claimants who have:

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    no exertional limitations, but who have impairment-related limitations affecting their ability to do the nonexertional demands of work; or

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    exertional limitations, but whose impairment-related nonexertional limitations are consistent with a finding of “disabled” without further analysis of their exertional limitations.

See “Using Rule 204.00” in DI 25025.010.

b. What are the nonexertional demands of work?

We categorize the nonexertional demands of work as:

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    mental;

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    postural (balancing, climbing, stooping, crouching, kneeling, crawling);

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    manipulative (reaching, handling, fingering, feeling);

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    visual (near acuity, far acuity, depth perception, accommodation, color vision, field of vision);

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    communicative (hearing, speaking); and

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    environmental (extreme cold, extreme heat, wetness, humidity, noise, vibration, atmospheric, hazards).

We define these terms in the Medical-Vocational Quick Reference Guide in DI 25001.001.

2. The rules in Tables No. 1, 2, and 3 of the medical-vocational guidelines

a. Whom do we evaluate under the rules in the tables?

We use the rules in Tables No. 1, 2, and 3 for claimants who have impairment-related limitations that affect the ability to do the exertional demands of work.

b. What are the exertional demands of work?

We categorize the exertional demands of work as:

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    walking,

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    standing,

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    sitting,

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    lifting,

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    carrying,

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    pushing, and

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    pulling.

We define these terms in the Medical-Vocational Quick Reference Guide in DI 25001.001.

c. How do we apply the rules in the tables?

We use the rules in:

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    Table No. 1 for claimants who are capable of performing the demands of sedentary work;

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    Table No. 2 for claimants who are capable of performing the demands of light work; and

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    Table No. 3 for claimants who are capable of performing the demands of medium work.

We define these exertional levels of work in § 404.1567 and § 416.967 of the regulations and in the Medical-Vocational Quick Reference Guide in DI 25001.001.

C. Underlying policy for the medical-vocational guidelines

1. The issue of work adjustment

The medical-vocational guidelines address the issue of ability to adjust to other work based on the interaction of the claimant’s RFC with their vocational factors of age, education, and past work experience.

When a rule directs:

  • •

    a determination of not disabled, we find the claimant capable of adjusting to other work; or

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    a determination of disabled, we find the claimant does not have the ability to adjust to other work.

2. Occupational base

Occupational base consists of the unskilled occupations a claimant is capable of performing considering the claimant’s impairment-related limitations. Some claimants may additionally have semiskilled or skilled occupations they are capable of performing based on transferable skills or recent education that provides for direct entry into skilled work.

See “Transferability of Skills Assessment Policy” in DI 25015.017 for further information about transferable skills and the Medical-Vocational Quick Reference Guide in DI 25001.001 for further information about direct entry.

NOTE: The occupational base considered in each rule consists of those unskilled occupations identified at the exertional level for that rule.

3. Significant numbers of jobs

The medical-vocational guidelines address the question of whether work exists in the national economy in significant numbers considering the claimant’s RFC and vocational factors of age, education, and past work experience. When a medical-vocational rule directs a determination of not disabled, work exists in significant numbers in the national economy to which the claimant can adjust.

When we published the medical-vocational rules, we were able to identify approximately:

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    200 unskilled sedentary occupations;

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    1600 unskilled sedentary and light occupations; and

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    2500 unskilled sedentary, light, and medium occupations.

in our national economy.

NOTE: Each unskilled occupation represents numerous jobs in the national economy.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0425025001
DI 25025.001 - The Medical-Vocational Guidelines - 03/06/2024
Batch run: 12/06/2024
Rev:03/06/2024