The Medical-Vocational Guidelines are used by Social Security to determine disability due to exertional impairments at step 5 of the sequential evaluation process.
The guidelines, or the "grids," consider a claimant's exertional level (that's the medical part) and the claimant's age, education and work history (the vocational factors). Depending upon these medical-vocational factors, the SSA determines that a person is either disabled or not disabled.
The purpose of the guidelines is to allow the SSA to decide thousands and thousands of claims without resorting to individualized vocational evidence for each one.
In general, the grids are not where you want to be as a claimant, because the grids direct a finding of "not disabled" in most situations. In fact, every claimant loses under the grids until age 50 (or age 45 if unable to communicate in English).
However, the grids are a two-edged sword. Once you reach the age of 50 (and have no transferable skills nor education that allows direct entry into skilled work), the grids direct a finding of "disabled" at the sedentary exertional level. The SSA presumes that the transition to unskilled sedentary work is too difficult for these claimants. At age 55, that same claimant grids "disabled" at the light exertional level.
Let's look at an example to see how the grids operate.
Consider a worker was 53 years old as of his alleged onset date. He has a high school education and past relevant work as a painter, which is a medium exertional job.
Due to the claimant's physical impairments, Social Security assessed a residual functional capacity (RFC) at the light exertional level. As a result, Social Security found that the claimant could no longer perform his past work at step 4 of the sequential evaluation process.
However, at step 5 Social Security used Rule 202.14 of Medical-Vocational Guidelines to determine that the claimant was not disabled. The claim was therefore denied.
Here is a plan to win a case like this with the help of the grids:
First, obtain a medical source statement from the claimant's doctors to get their assessment of his RFC. I use these medical opinions to try to persuade SSA that the claimant's true RFC is at the sedentary exertional level. Since he is over age 50 and has no transferable skills, he would grid "disabled" at sedentary, and would then receive disability benefits.
Second, time is marching on, and the claimant's 55th birthday is less than six months away. Social Security has a regulation stating that the age categories of the guidelines should not be applied "mechanically." See 20 CFR 404.1563(b). The POMS has a provision that describes the factors to be considered when deciding the appropriate age category in borderline situations such as this. See POMS section DI 25015.005. I cite these authorities and explain that our claimant should be considered a person of "advanced age" right now. As a person of advanced age, he would grid "disabled" even at the light exertional level.
That is a simple example of how the grids operate. The example also demonstrates how a Social Security disability lawyer analyzes a case and develops a winning theory for the case. Developing a winning theory at the beginning of a case is perhaps a disability lawyer's most important task, and it is the aspect of my disability law practice that I enjoy the most.