(PPS-103)
SSR 83-12
SSR 83-12: TITLES II AND XVI: CAPABILITY TO DO OTHER WORK -- THE
MEDICAL-VOCATIONAL RULES AS A FRAMEWORK FOR EVALUATING EXERTIONAL
LIMITATIONS WITHIN A RANGE OF WORK OR BETWEEN RANGES OF WORK
PURPOSE: To clarify policies applicable in using the numbered
table rules in Appendix 2 of Subpart P of the regulations as a framework
for adjudicating claims in which an individual has only exertional
limitations, and no specific rule applies because the individual's
residual functional capacity (RFC) does not coincide with any one of the
defined exertional ranges of work.
CITATIONS (AUTHORITY): Sections 223(d)(2)(A) and 1614(a)(3)(B) of
the Social Security Act; Regulations No, 4, Subpart P, sections
404.1520(f), 404.1545, 404.1561, 404.1566, 404.1567, 404.1569; Appendix 2
of Subpart P, section 200.00(d); Regulations No. 16, Subpart I, sections
416.920(f), 416.945, 416.961, 416.966, 416.967, and 416.969.
PERTINENT HISTORY: If a person has a severe medically determinable
impairment which, though not meeting or equaling the criteria in the
Listing of Impairments (Regulations No. 4, Subpart P, Appendix 1),
prevents the person from performing past relevant work, we must decide
whether he or she can do other work. The Medical-Vocational Guidelines
which follow Appendix 1 as Appendix 2 contain numbered table rules which
direct conclusions of "Disabled" or "Not disabled" where all of the
individual findings coincide with those of a numbered rule. The table
rules do not direct such conclusions when an individual's exertional RFC
does not coincide with the exertional criteria of any one of the external
ranges, i.e., sedentary, light, medium, as defined in sections 404.1567
and 416.967 of the regulations (See SSR
83-10, PPS-101, Determining Capability to Do Other Work -- The
Medical-Vocational Rules of Appendix 2, for a discussion of exertion and
ranges of work.) In some instances, an individual can do a little more or
less than the exertion specified for a particular range of work; e.g., the
person is considered to be physically capable of meeting the exertional
demands of light work except that he or she can lift no more than 15
pounds at a time rather than 20 pounds, or he or she can fully meet the
exertional demands of light work and can also perform part of the greater
lifting requirement of medium work (such as up to 30 pounds at a time
rather than 50 pounds at a time).
This Program Policy Statement (PPS) sets out the process of using the
numbered rules in adjudicating those claims in which the exertional
components of the RFC are less or greater than those of a specifically
defined exertional range of work.
POLICY STATEMENT: Each numbered rule directs a conclusion as to
whether an individual in a specific case situation is able to make an
adjustment to work other than that previously performed. The decision is
based on the person's remaining occupational base, as determined by RFC,
in conjunction with his or her age, education, and work experience. (See
the text and work experience. (See the text and glossary of
SSR 83-10, PPS-101, Determining
Capability to Do Other Work -- The Medical-Vocational Rules of Appendix
2.)
Where an individual exertional RFC does not coincide with the definitions
of any one of the ranges of work as defined in sections 404.1567 and
416.967 of the regulations, the occupational base is affected and may or
may not represent a significant number of jobs in terms of the rules
directing a conclusion as to disability. The adjudicator will consider the
extent of any erosion of the occupational base and access its
significance. In some instances, the restriction will be so slight that it
would clearly have little effect on the occupational base. In cases of
considerably greater restriction(s), the occupational base will obviously
be affected, In still other instances, the restrictions of the
occupational base will be less obvious.
Where the extent of erosion of the occupational base is not clear, the
adjudicator will need to consult a vocational resource. The publications
listed in sections 404.1566 and 416.966 of the regulations will be
sufficient for relatively simple issues. In more complex cases, a person
or persons with specialized knowledge would be helpful. State agencies may
use personnel termed vocational consultants or specialists, or they may
purchase the services of vocational evaluation workshops. Vocational
experts may testify for this purpose at the hearing and appeals levels. In
this PPS, the term vocational specialist (VS) describes all vocational
resource personnel.
Adjudicative Guidance
The rules provide a basis for equitable consideration of the remaining
occupational base, as follows:
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1. If the individual's exertional capacity falls between two rules which
direct the same conclusion, a finding of "Disabled" or "Not disabled," as
appropriate, will follow.
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a. As an example, where an exertional RFC is between the sedentary and
light exertional levels and a finding of "Disabled" is indicated under
both relevant rules, a finding of "Disabled" will follow. Even the
complete occupational base (light) would not represent significant work
for the individual.
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b. As a second example, where an exertional RFC is between medium and
light work, and both relevant rules, direct a conclusion of "Not
disabled," the occupational base is clearly more than what is required as
representing significant numbers of jobs because even the rule for less
exertion directs a decision of "Not disabled."
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2. If the exertional level falls between two rules which direct opposite
conclusions, i.e., "Not disabled" at the higher exertional level and
"Disabled" at the lower exertional level, consider as follows:
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a. An exertional capacity that is only slightly reduced in terms of the
regulatory criteria could indicate a sufficient remaining occupational
base to satisfy the minimal requirements for a finding of "Not
disabled."
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b. On the other hand, if the exertional capacity is significantly reduced
in terms of the regularity definition, it could indicate little more than
the occupational base for the lower rule and could justify finding of
"Disabled."
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c. In situations where the rules would direct different conclusions, and
the individual's exertional limitations are somewhere "in the middle" in
terms of the regulatory criteria for exertional ranges of work, more
difficult judgments are involved as to the sufficiency of the remaining
occupational base to support a conclusion as to disability. Accordingly,
VS assistance is advisable for these types of cases.
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3. Another situation where VS assistance is advisable is where an
individual's exertional RFC does not coincide with the full range of
sedentary work. In such cases, equally difficult judgments are involved.
Rather than having two rules which direct either the same or opposite
conclusions, the decisionmaker would have only one relevant rule and would
have to decide whether the full range of sedentary work is significantly
compromised.
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A VS can assess the effect of any limitation on the range of work at
issue (e.g., the potential occupational base); advise whether the impaired
person's RFC permits him or her to perform substantial numbers of
occupations within the range of work at issue; identify jobs which are
within the RFC, if they exist; and provide a statement of the incidence of
such jobs in the region in which the person lives or in several regions of
the country.
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a. Where an individual's impairment has not met or equal the criteria of
the Listing of Impairments at an earlier step in the sequence of
adjudication, but the full range of sedentary work is significantly
compromised, section 201.00(h) of Appendix 2 provides that a finding of
"Disabled" is not precluded for even younger individuals. (The example in
that section are of significantly restricted occupational bases.)
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b. Where a person can perform all of the requirements of sedentary work
except, for example, a restriction to avoid frequent contact with
petroleum based solvents, there is an insignificant compromise of the full
range of sedentary work. Technically, because of the restriction, this
person cannot perform the full range of sedentary work. However, this
slight compromise within the full range of sedentary work (i.e.,
eliminating only the very few sedentary jobs in which frequent exposure to
petroleum based solvents would be required) leaves the sedentary
occupational base substantially intact. Using the rules as a framework, a
finding of "Not disabled" would be appropriate.
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Consideration of restrictions less clear in their effect than in the
examples cited will require a more detailed review of the impact of the
particular limitations on the performance of the full range of sedentary
work. The assistance of a VS will usually be required in assessing the
extent of the reduced work capabilities caused by the limitations. The
particular examples set out above illustrate cases in which nonexertional
impairments impinge upon the full range of sedentary work. Using the rules
as a framework, the same principals may be applied to determine whether
there has been a significant compromise in those instances where
additional exertional limitations impinge on the full range of sedentary
work.
SPECIAL SITUATIONS
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1. Alternate Sitting and Standing
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In some disability claims, the medical facts lead to an assessment of RFC
which compatible with the performance of either sedentary or light work
except that the person must alternate periods of sitting and standing. The
individual may be able to sit for time, but must then get up and stand or
walk for awhile before returning to sitting. Such an individual is not
functionally capable of doing either the prolonged sitting contemplated in
the definition of sedentary work (and for the relatively few light jobs
which are performed primarily in a seated position) or the prolonged
standing or walking contemplated for most light work. (Persons who can
adjust to any need to vary sitting and standing by doing so at breaks,
lunch periods, etc., would still be able to perform a defined range of
work.)
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There are some jobs in the national economy -- typically professional and
managerial ones -- in which a person can sit or stand with a degree of
choice. If an individual had such a job and is still capable of performing
it, or is capable of transferring work skills to such jobs, he or she
would not be found disabled. However, must jobs have ongoing work
processes which demand that a worker be in a certain place or posture for
at least a certain length of time to accomplish a certain task. Unskilled
types of jobs are particularly structured so that a person cannot
ordinarily sit or stand at will. In cases of unusual limitation of ability
to sit or stand, a VS should be consulted to clarify the implications for
the occupational base.
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2. Loss of Use of an Upper Extremity
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A person who has lost the use of an arm or hand because of amputation,
paralysis, etc., obviously cannot perform jobs which require use of both
arms or both hands. Loss of major use of an upper extremity is rather
definitive in that there is a considerable absence of functional ability.
As stated in SSR 82-51, PPS-85, Guidelines for Residual Functional
Capacity Assessment in Musculoskeletal and Cardiovascular Impairments, an
amputation above the elbow would limit a person to light work activity
with additional limitations because of loss of bimanual manipulation and
difficulty or inability to handle bulky objects; effective use of the
remaining hand may also be affected. An amputation below the elbow -- or
partial loss of use of the extremity -- will require a more detailed
evaluation of functional ability, including the condition of the remaining
stump and the person's ability to use a prosthesis -- or the person's
remaining ability for fine and gross manipulating.
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Experience with persons who have lost the use of an upper extremity has
shown that their potential occupational base is between the occupational
bases for Table No. (sedentary work) and Table No.2 (light work). While
individuals with this impairment have been known to perform selected
occupations at nearly all exertional levels, the total number of
occupations within their RFC's is less than the number represented by a
full or wide range of light work. These individuals would generally not be
expected to perform sedentary work because most unskilled sedentary jobs
require good use of both hands. Persons who have the least remaining
function would have only the lower occupational base, while those who have
the most remaining function would have some of the higher occupational
base added in terms of numbers of jobs which can be performed with this
type of impairment. Given an individual's particular RFC, a VS will be
able to determine the size of the remaining occupational base, cite
specific jobs within the individual's RFC, and provide a statement of the
incidence of those jobs in the region of the individual's residence or in
several regions of the country.
The Disability Determination or Decision Where a Claimant or
Beneficiary Has Exertional Limitations Within A Range of Work or
Between Ranges of Work
The usual requirements apply for a clear, persuasive, orderly rationale,
reflecting the sequential evaluation process, with recitations of the
evidence and specific findings of fact. (See SSR 82-56, PPS-81, The
Sequential Evaluation Process.) Whenever vocational resources are used,
and an individual is found to be not disabled, the determination or
decision will include (1) citations of examples of occupation/jobs the
person can do functionally and vocationally and (2) a statement of the
incidence of such work in the region in which the individual resides or in
several regions of the country.
EFFECTIVE DATE: Final regulations providing the
Medical-Vocational Guidelines were published in the Federal
Register November 28, 1978, at 43 FR 55349, effective February 26,
1979. They were rewritten to make them easier to understand and were
published on August 20, 1980, at 45 FR 55566. The policies in this PPS are
effective as of February 26, 1979.
CROSS-REFERENCE: Program Operations Manual System, Part 4
(Disability Insurance State Manual Procedure), sections DI 2380E, 2382.2,
2384, and 2388A-E; SSR 83-10, PPS-101,
Determining Capability to Do Other Work -- The Medical-Vocational Rules of
Appendix 2; SSR 83-11, PPS-102,
Capability to Do Other Work -- The Exertionally Based Medical-Vocational
Rules Met; SSR 83-13, PPS-104, Capability to Do Other Work -- The
Medical-Vocational Rules as a Framework for Evaluating Solely
Nonexertional Impairments; and SSR
83-14, PPS-105, Capability to Do Other Work -- The Medical-Vocational
Rules as a Framework for Evaluating a Combination of Exertional and
Nonexertional Impairments.
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