The claimant is 60 years old, and has been a hospital nurse for over 25 years. Now, due to fibromyalgia, coronary disease, bilateral carpel tunnel syndrome and other impairments, she can no longer perform her past relevant work as a nurse.
DDS assessed a light exertional RFC. For a 60 year old claimant with an unskilled work background, that would have been the end of the process. The claim would have been granted according to Medical-Vocational Rule 202.06 (light RFC, advanced age, no transferable skills or education allowing direct entry to skilled work). But DDS decided that the skills from her SVP 7 nurse job would transfer to three other SVP 7 nursing jobs performed at the light exertional level:
- nurse supervisor, DOT Code 075-167-010
- office nurse, DOT Code 075-374-014
- school nurse, DOT Code 075.124-010
As a result, the claim was denied under Medical-Vocational Rule 202.07.
I have reviewed the Social Security disability claim file, and there is not an actual transferable skills analysis anywhere to be found. Social Security has specific rules for transferable skill determinations. Since the existence of transferable skills can make the difference between winning and losing a claim, these rules are critically important.
Medical-Vocational Guidelines Section 202.00(f) states:
For a finding of transferability of skills to light work for persons of advanced age who are closely approaching retirement age (age 60 or older), there must be very little, if any, vocational adjustment required in terms of tools, work processes, work settings, or the industry.
Social Security Ruling 82-41 elaborates:
In order to establish transferability of skills for such individuals, the semiskilled or skilled job duties of their past work must be so closely related to other jobs which they can perform that they could be expected to perform these other identified jobs at a high degree of proficiency with a minimal amount of job orientation.
I see two potential problems right away with the DDS vocational determination. First, the DOT job descriptions of the other three nursing jobs contain some different skills than those acquired from the generic nurse job. In particular, the job of nurse supervisor has a whole set of supervision and management skills that are not part of the job description of a regular nurse. Second, each of the three light exertional nursing jobs may require a significant vocational adjustment, contrary to 202.00(f) and Ruling 82-41. Resolving these issues will probably require a hearing.
The claim also needs medical development. The claimant stopped working largely because she could not be on her feet all day, as required by her job. So the DDS light exertional RFC is beyond the claimant’s actual abilities. Medical source statements from her doctors are likely to describe a sedentary RFC, which would rule out those three nursing jobs, and would resolve the issue of transferable skills.
Lastly, the claimant has good days and bad days with her fibromyalgia. So there is also the issue of whether or not she is able to work on a sustained basis.
Each of these areas will be developed. If the new evidence is particularly strong, I will make an on the record request, and try to obtain a fully favorable decision without my client having to wait for a hearing.