When you apply for disability benefits with the Social Security Administration (SSA), you may apply for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), or sometimes both. Under either program, the definition of disability is the same and you might qualify for what is known as a medical-vocational allowance.
In evaluating whether you are disabled, the SSA follows a 5-step sequential evaluation process. First, the SSA will assess whether or not you are engaging in substantial gainful activity (generally, this means earning at least $1,090 per month for 2015). Second, the SSA will evaluate whether your impairment is severe. Third, the SSA will determine whether your impairment meets or equals all of the criteria of one of the impairments in its publication known as the Listing of Impairments. If your impairment does meet or equal in severity a listed impairment, you will be found disabled and granted benefits.
If the SSA determines that your impairment does not meet or equal the requirements of a specific listed impairment, the disability evaluation doesn't end. Although the medical evidence alone hasn't established that you are disabled, the SSA will continue its sequential evaluation process by assessing your remaining functional capacity for work and by considering your age, education and work experience. You could still qualify for disability benefits if you are approved for a medical-vocational allowance. In fact, most disability claimants who win disability benefits are granted benefits under a "med-voc allowance."
Based on all of the medical and other relevant evidence in your case record, the SSA will assess what is known as your residual functional capacity (RFC). Your RFC represents the most that you can do in terms of work-related activities despite the limitations or restrictions resulting from your impairment.
An assessment of your RFC will include an evaluation of your ability to perform physical functions such as sitting, standing, walking, lifting, carrying, pushing, and pulling. These seven strength demands are referred to as your "exertional" capacity. In general, your RFC will be stated in terms of the exertional categories of sedentary work, light work, medium work, or heavy work.
The assessment will also include an evaluation of your "nonexertional" capacity, which includes the ability to perform other physical functions such as stooping, bending, seeing, and speaking. Nonexertional capacity also includes any mental limitations such as your ability to follow direction and interact socially.
Once the SSA has assessed your RFC, it will evaluate whether or not you can perform any of your past jobs. The SSA will compare your RFC with the physical and mental demands of your past relevant work. If the SSA finds that you do not have the RFC to perform your past job, the disability evaluation will continue on to see if you can perform any other jobs.
At the final step of the disability evaluation process, the SSA will determine if you have the ability to "adjust" to other work, by considering your RFC along with "vocational" factors such as age, education, and work experience. If the SSA finds that you have the capability to do any other job, you will be found not disabled. However, if the SSA finds that your RFC and vocational factors prevent you from learning or adjusting to other work, you will be found disabled and awarded benefits.
Vocational factors are age, education, and job history.
Your age is a big factor in determining whether your RFC allows you to do "other work." In general, the older your age, the more likely age will be seen as a negative vocational factor, and you'll be less likely to be expected to learn or adjust to a new job. If you are between the ages of 18 and 49, the SSA defines you as a "younger individual." If you are between the ages of 50 and 54, you are "closely approaching advanced age." At age 55 and over, you are a person of "advanced age," and you are much less likely to be able to adjust to other work.
Education refers to what level of school you completed. Your education level is classified into the following groups: illiterate or unable to communicate in English, marginal (less than 7th grade), limited (less than 12th grade), or high school or more.
Your work experience is categorized as none, unskilled, semi-skilled, or skilled.
The SSA has developed specific rules in a series of tables known as the Medical-Vocational Guidelines (also called the med-voc guidelines, or the "grid"). Each rule sets forth specific combinations of the relevant factors (your RFC, age, education, and work experience) that determine whether the SSA will expect you to do other work. Where your RFC and vocational factors match the criteria set forth in a specific rule, the SSA must apply the rule, and the rules says whether or not you are disabled.
The med-voc guidelines are a way for the SSA to make sure that disability rules are applied consistently. The disability reviewer just needs to find your specific vocational profile in the grid to determine whether you are disabled or not.
The grid is made up of tables based on each physical RFC level: sedentary work, light work, medium work, and heavy work. For example, if your RFC is for sedentary work and you are 50 years or older, didn't graduate from high school, and have only worked in unskilled jobs, you will be considered disabled, via a medical-vocational allowance. If you are 45 years old with same background, you won't be considered disabled.
In general, if you are age 50 or over, you have a better chance of being granted a medical-vocational allowance. Likewise, if you are a younger person, you may have a difficult time being granted benefits under a med-voc allowance.
If your factors don't match the exact criteria of a rule (for example, you have an RFC for more than sedentary work but for less than the full range of light work), the claims examiner or administrative law judge at the SSA will use the med-voc guidelines as a frame of reference for deciding whether you are disabled or not.
The med-voc guidelines control whether you are disabled or nondisabled only if you have an impairment that causes difficulties in meeting the exertional, or strength, demands of a job. If you only have nonexertional limitations (for example, you must use the restroom frequently) or mental limitations (for example, you have a reduced ability to follow direction due to a mental impairment), the SSA will use the med-voc guidelines only as a frame of reference for the disability determination.