Social Security Rulings Summary
Social Security Rulings are made by the Social Security Administration. These are inter-agency rulings and are not set directly by Congress. However, many times the rulings are a result of the laws set by Congress or court decisions. The rulings govern the agency’s conduct and are suppose to be followed by the Social Security judges and other officials within the Social Security Administration.
SSR 79-19: Right to Appear at a Hearing, Waiver
You have a right to personally appear at a hearing and present evidence. You have a right to be represented. You may waive your right to a personal appearance at a hearing if it is in writing. If you waive your right to a personal appearance at a hearing, then the case will be decided solely on the written evidence in your file.
SSR 82-41: Work Skills, Transferability of Skills, Documentation Required by the Judge
You can only obtain a work skill by experience directly connected to an art, science or trade when combined with the ability to apply the knowledge and experience. This ruling gives examples of skills such as operating machinery, making precise measurements, and reading blueprints. A person with a skill has an advantage over an unskilled worker in the labor market. The Social Security judge must make findings of fact related to whether or not your skills would transfer to another job. These findings of fact must be in his or her written decision. If the Social Security judge finds that your prior skills are transferable to other jobs, then the judge must identify those jobs in the national economy. The numbers of those skilled jobs must be stated in the judge’s written decision.
SSR 82-59: Not following Prescribed Treatment, Inability to Follow Treatment
The Social Security judge may deny your claim for disability benefits based on your failure to follow prescribed treatment. The following conditions must exist in order for the judge to deny benefits:
• The evidence shows that your impairment keeps you from doing any work.
• Your impairment has lasted or is expected to last for 12 continuous months from onset of disability or is expected to result in death.
• Your treating medical professional has prescribed treatment that is clearly expected to restore your capacity to engage in work.
• The evidence in your case shows that there has been a refusal to follow prescribed treatment.
The Social Security judge cannot rely on the opinion of a consultative doctor or non-treating doctor as a basis for finding that you failed to follow prescribed treatment.
You are allowed to have certain justifiable reasons for failing to follow treatment. Also, if you cannot afford treatment, then you will be excused. You can’t afford treatment when free community resources are unavailable.
82-61: Past Relevant Work
The Social Security judge must decide if you can perform your past relevant work. The judge should look at things like: whether you have a functional capacity to perform a past job based on a broad occupational classification of that job (job description); whether you have a functional capacity to perform a prior job as you actually performed it; or whether you have a functional capacity to perform a prior job as ordinarily required by employers in the national economy.
If the judge finds that you do have the functional capacity to perform your prior relevant job duties under any of the three ways listed above, then the judge is required to find that you are not disabled.
SSR 82-62: 15-Year Rule for Past Relevant Work, Required Findings for Past Relevant Work
Past work is not considered past relevant work unless the work was performed within 15 years prior to the date last insured. The Social Security judge must make findings of fact and develop the record regarding the physical and mental demands of your past relevant work. This means the judge must put these findings of fact into the written decision and more specifically, address the following in the written decision: identify what your functional capacity is; identify what the physical and mental demands of your past job was; and decide whether your functional capacity would allow you to return to your past job. The Social Security judge must be logical and orderly in stating these findings in the written decision.
The judge must make findings of fact about your mental demands of your prior work and include this in the written decision.
The judge must analyze the impact of stress from such things as a cardiac impairment or gastro-intestinal disorder on your ability to perform your prior work and include this finding in the written decision.
SSR 83-5a: The Medical-Vocational Guidelines (Grids) Rules are conclusive
Sometimes, your age, education and prior work require that the Social Security Administration decide the case favorably ( a presumption of disability). The Social Security judge cannot rely on the testimony of a Vocational Expert to rebut the presumption of disability in certain cases.
SSR 83-10: Capability to do Other Work, Light and Medium Work, Definitions of Terms
Residual Functional Capacity (RFC) is a medical assessment of what you can do in a work setting in spite of the functional limitations and environmental restrictions imposed by all of your impairments. In other words, RFC is your capacity to perform the physical and mental duties of certain jobs, in spite of your medical problems.
Light work is defined as lifting no more than 20 lbs at a time with frequent lifting or carrying objects weighing up to 10 lbs. Normally, a good deal of walking or standing is required for light work. Frequent means from 1/3 – 2/3 of the time. Light work requires walking or standing, off and on, for a total of 6 hrs of an 8hr workday. Normally, for light work, only occasional stooping is required. The use of the arms and hands are more important than the use of the fingers. The ability to stand and walk during most of the workday is very important for light work and this is the primary difference between light work and sedentary work (sedentary work requires much less standing and walking). The full range of light work requires standing or walking, off and on, for a total of 6 hrs out of an 8 hr workday.
Medium work is defined as lifting no more than 50 lbs at a time with frequent lifting or carrying of objects weighing up to 25 lbs. Standing or walking, off and on, for a total of approximately 6 hrs in an 8hr workday is required for medium work. The use of your hands and arms is more important than using your fingers. Medium work requires that you have flexibility of your knees and torso.
Nonexertional impairment means any impairment that does not directly affect the ability to sit, stand, walk, lift, carry, push or pull. We are talking about impairments which affect the mind, vision, hearing, speech, and use of the body to stoop, kneel, crouch, climb, balance, crawl, reach, handle, and use the fingers for fine activities.
SSR 83-11: Exertional Impairments
The Social Security judge cannot determine that you fit within a functional capacity to apply the presumptive rules (Grid Rules) unless you can perform all or substantially all of the work at that exertional level.
SSR 83-12: Exertional Capacity That Falls Between two Grid Rules, Need for VE Testimony for Sit/Stand Option and Loss of Use of Upper Extremity
If your exertion level falls between two levels of the Grids which call for opposite conclusions (not disabled at the higher exertional level and disabled at the lower exertional level), you should still be found disabled if there are not many jobs you could perform. If there is a question about the number of jobs you could perform, then a Vocational Expert should be called to testify.
Unskilled jobs normally will not allow you to sit and stand at will.
The testimony of a Vocational Expert is needed if you have limited use of your arm(s) or hand(s).
SSR 83-14: Combination of Exertional and Non-exertional Limitations, Limited Public Contact, Documentation for Transferable Skills
If you have a limitation on the use of your fingers, this will affect your ability to work. This is known as a non-exertional impairment.
If you are limited in the amount of public contact when you work, this is a significant restriction and could affect your ability to work in an unskilled job. A vocational expert would need to testify on concerning this restriction.
The Social Security judge must give examples of jobs you can perform and how many there are in the national economy if he or she finds that you are not disabled.
SSR 83-20: Establishing Onset Dates
In determining the onset date of your disability, the Social Security judge should at least start with your statement as to when your disability started. It may be reasonable for the judge to infer a date of onset that comes before the date of your first medical examination. The judge may call a medical advisor or doctor to testify when your onset date of disability must be inferred. It may be necessary for family members, friends, and former employers to testify about your onset date of disability.
SSR 85-15: Mental Demands of Unskilled Work, Reaching, Handling, Fingering, Stooping, and Environmental Limitations
When the judge is assessing your mental functional capacity, he or she must make findings about your ability to perform basic work-related activities. Basic mental work requirements for unskilled work include the ability to remember and carry out simple instructions; to respond appropriately to a supervisor, coworkers, and usual work situations; and to deal with work setting changes. A finding of disabled is justified when there is a substantial loss in the ability to do any of these.
If you need limited public contact in order to work, this is a significant nonexertional limitation. The judge will need to call a Vocational Expert to testify about the limitation.
If you are limited to low-stress jobs, then a Vocational Expert will need testify about your ability to work.
The judge will also need to consider your limitations in reaching and handling in deciding whether you can work. Significant limitations of reaching or handling may not allow for work since handling, holding, grasping are required for most jobs. The Social Security judge should call a Vocational Expert to testify about your manipulative limitations.
The Social Security judge should call a Vocational Expert to testify if you have environmental limitations such as noise, dust, irritants, and pollutants.
SSR 96-2p: How to Evaluate Medical Opinions
The Social Security judge must give good reasons for the weight given to your treating source’s medical opinion. The judge must consider certain factors in assessing your treating doctor’s opinion. These factors include the length of your treatment, frequency of examination, nature and extent of the treatment relationship, is the opinion supported by the medical evidence, consistency of the opinion and the doctor’s specialization.
SSR 96-3p: Definition of Severe
An impairment is “severe” if it significantly limits an individual’s physical or mental abilities to do basic work activities. An impairment that is not severe means it is only a slight abnormality and would have only a minimal effect on the ability to work.
SSR 96-5p: Treating Source Opinions
The Social Security judge must seriously consider your doctor’s opinion and can never just ignore the opinion. The judge should consider the factors in SSR 96-2p in assessing your treating doctor’s opinion. Sometimes, the judge is required to contact the treating source for clarification. The judge cannot assume that your doctor knows the definition of the work terms used by the Social Security Administration (i.e. “sedentary work” and “light work”).
SSR 96-6p: State Agency Opinions are Treated as Expert Opinions
The opinions of State agency consultants (i.e., Disability Determination Services in N.C.) are considered to be expert opinion evidence of nonexaming sources. The judge cannot ignore these opinions and must explain the weight given to these opinions in his or her written decision. The judge is not bound by any of the findings made by a State agency consultant, however, the judge must give adequate reasons for rejecting these non-examining State agency medical consultants.
SSR 96-7p: Evaluating Symptoms and Credibility
The Social Security judge must consider the State agency doctor’s findings of fact and credibility in the written decision. The Social Security judge must be consider whether you have a true medical impairment that could reasonably be expected to produce your pain or other symptoms. If you have a witness to testify at your hearing about your impairments, then the judge must consider these statements about your symptoms and how they affect you.
The judge must consider medication side effects, type, dosage, and effectiveness.
The judge must consider your allegations of pain and be very detailed about how he or she analyzed your credibility in the written decision. In other words, the judge is not allowed to just state that your allegations are not credible – the reasons must be given for not believing your complaints of pain and other symptoms. Ongoing efforts to obtain pain relief support your credibility. However, the judge must consider the failure to obtain pain relief in gauging your credibility, but there are valid reasons for not obtaining treatment:
• your daily activities may be structured to lessen your symptoms
• your symptoms may not be severe enough to justify treatment
• over-the-counter medications use
• medications side effects are less tolerable than your symptoms
• you may not be able to afford treatment and may not have access to free or low cost medical services
• your treating medical source may have told you that there is no effective treatment
• the medical treatment offered may be against your religion
SSR 96-8p: Definition of RFC (Residual Functional Capacity)
RFC means an assessment of your ability to do sustained work related physical and mental activities in a work setting on a regular and continuing basis (8 hrs/day, 5 days/wk). The judge must first identify your functional limitations and go thru a function by function assessment for each work ability, based on all of the relevant evidence in the record. After that, the judge may set the RFC as sedentary, light, medium, heavy, and or very heavy. Your RFC is not the least you can do with your limitations, but it is the most you can do with your limitations. If the RFC set by the judge conflicts with a medical source, the judge must explain why he or she did not adopt that opinion.
If your treating doctor has given an opinion on the nature and severity of your impairments and the opinion is well supported by the medical evidence, the judge must give the opinion controlling weight, unless it is inconsistent with other substantial evidence in the record.
The judge must consider “severe” and “non-severe” impairments in setting your RFC.
The judge must include detailed findings as to the setting of your RFC within the written decision.
The judge must include a “function-by-function” assessment when setting your RFC. Exertional and nonexertional factors must be considered. Each function must be considered separately.
The same language used in SSR 83-15 for assessing your mental RFC is used in this ruling. In addition to setting a mental RFC, the judge must complete a Psychiatric Review Technique form for mental impairments.
The judge must consider side effects from your medications when setting your RFC.
SSR 96-9p: Sedentary Work
Sedentary work means lifting no more than 10 lbs at a time and occasionally lifting or carrying files and small tools. A sedentary job will normally involve sitting most of the workday, but will also require walking and standing occasionally. Occasionally means a total of no more than 2 hrs in an 8 hr workday.
Good use of your hands is required for sedentary work. However, this does mean good use of both hands is needed. This is called bilateral manual dexterity.
Using a cane, walker, or crutch could have an impact on your ability to do sedentary work. This includes any assistive device used to maintain your balance. Problems stooping could affect your ability to do sedentary work since the ability to stoop occasionally is required for unskilled sedentary work.
Problems with your vision could interfere with your ability to do sedentary work since most sedentary unskilled jobs require working with small objects.
The only breaks in an 8 hr day are a morning break, a lunch and an afternoon break, with 2 hrs of work between the breaks.
The mental demands of unskilled sedentary work are covered in SSR 83-15 and 96-8p.
SSR 00-4p: Vocational Expert Testimony
The Social Security judge cannot rely on the testimony of a Vocational Expert if the testimony is inconsistent with the rules and policies of the Social Security Administration. The judge must ask the Vocational Expert about any conflict between the Vocational Expert evidence and the Dictionary of Occupational Titles. The judge must obtain a reasonable explanation for any such conflict. The judge must state in the written decision how he or she resolved the conflict.
If you do not have transferable skills, then you cannot perform semi-skilled work.
SSR 02-01p: Obesity
Obesity can cause limitations in lifting, carrying, sitting, standing, walking, pulling, pushing, climbing, balancing, manipulating, stooping, and crouching. Obesity can also involve limitations with extreme heat, humidity, or hazards. The Social Security judge is required to accept a diagnosis of obesity if given by a treating source or consulting examiner as long as there is no evidence to the contrary. A Body Mass Index of 30 or above constitutes obesity. There are 3 different levels of obesity with a BMI of 40 or above representing extreme obesity. The Social Security judge must assess the impact of your obesity on your ability to work. People with obesity can also have sleep apnea and thereby cause drowsiness and lack of mental clarity during the day.
SSR 02-2p Interstitial Cystitis (IC)
Interstitial cystitis is a chronic bladder disorder with urinary frequency, urinary urgency, and pelvic pain. It occurs most often in women. The Social Security Judge must recognize exertional limitations caused by this disorder. A mental impairment such as anxiety, depression and memory loss may accompany this disorder. The judge must adequately evaluate your mental impairment that occurs with interstitial cystitis.
SSR 03-2p Reflex Sympathetic Dystrophy (RSDS)
RSDS is also known as Complex Regional Pain Syndrome, Type I. Normally, this disorder develops after trauma. Complaints of intense pain are common. There normally will be swelling, autonomic instability (changes in skin color or texture), changes in sweating, changes in skin temperature, abnormal hair growth and involuntary movements.
Extreme sensitivity to touch or pressure can be associated with this disorder. The medications prescribed for this disorder are of the type that would interfere with your ability to maintain attention and concentration. Opinions from treating doctors are very important so that the judge can assess the severity of the impairment and set the proper RFC. Younger persons are specifically considered under this rule even though they are less than 50 years old.
SSR 06-03p Acceptable Medical Sources
Acceptable medical sources are:
• Licensed physicians (medical or osteopathic doctors);
• Licensed or certified psychologists;
• Licensed optometrists
• Licensed podiatrists
• Qualified speech-language pathologists
Medical reports from the accepted medical sources should include an opinion about your ability to do work related activities such as sitting, standing, walking, lifting, carrying, handling objects, hearing, speaking, and traveling. For mental impairments, there should be an opinion from your accepted medical source concerning your ability to understand, to carry out and remember instructions, and to respond appropriately to supervision, coworkers, and work pressures in a work setting.
This rule allows for evidence from other sources to show the severity of your impairment and how it affects your ability to work.
Other medical sources include:
• Nurse-practitioners
• Physicians’ assistants
• Naturopaths
• Chiropractors
• Audiologists
• Therapists
Other non-medical sources include:
• Educational personnel (school teachers, counselors etc..)
• Social welfare agency personnel (social workers)
• Family members
• Caregivers
• Friends
• Neighbors
• Clergy
Sometimes the evidence from the non-medical sources can outweigh the opinion form a medical source. The reason for this is that family members, caregivers, and friends have close contact with someone who is disabled – they have personal knowledge to make judgments about your impairments and ability to function.
What Our Clients Say:
Member:
Attorney Gregory Kornegay
Greg is a trial attorney in Wilmington with over 30 years of experience. Greg was born and raised in southeastern North Carolina. Before law school he managed a store with employees making a payroll every week. His first job out of law school was as an Assistant District Attorney investigating and trying cases for the State of North Carolina. Through the years he has handled many different types of cases – including death penalty cases.
Being married with children has been a blessing and a challenge, but has served him well in understanding the problems individuals and families face as they live out their lives. Greg believes that each case is different and the needs of each client are unique, but there are certain themes of life that we all share.