Most disability claims are decided on a medical-vocational basis. Sometimes too little attention is paid to the vocational side of the analysis.
I had hearing recently that illustrated the importance of developing the vocational evidence for a disability claim. My client's sole past relevant work was a public insurance adjuster, who is a person hired by individuals to document property damage claims, and then submit the claims to insurance companies. His application for Social Security disability benefits had been denied by DDS on the theory that his "light" residual functional capacity (RFC) would allow performance of his past work as generally performed.
Whenever a claim is denied by DDS with a determination that past work can be done "as generally performed," that should raise a big red flag for the disability lawyer.
Upon review of the claim file, I found that the DDS vocational analysis equated my client's public adjuster job with an insurance adjuster that works for an insurance company (DOT Code 241.217-010). That job is a close cousin to my client's past work, but they are different jobs, and the public adjuster job requires much more physical activity for reasons that are readily explainable at a hearing.
I had the client write a detailed job description, which we filed into the disability claim file ahead of the hearing. I also prepared the client to testify about the aspects of an in-house insurance adjuster job that he did not know how to do, such as playing a role in litigation. At the hearing, he testified regarding the unique aspects of the public adjuster's job as well as the parts of the insurance company adjuster job for which he had not acquired job skills.
When it came time for the vocational expert (VE) to testify at the hearing, the VE stated that the public adjuster job was medium exertional work, both as performed by the claimant and as generally performed in the national economy. So even with the same DDS light RFC, he was unable to perform his past work. Further, the VE testifed that his skills would not transfer to other skilled work within the claimant's RFC, so medical-vocational rule 202.06 directs a finding of "disabled."
We also developed the medical aspects of the claim, of course. But the new vocational evidence gave the judge a way to grant the claim even based upon the DDS assessment of the claimant's functional limitations.
I had a similar situation again at a hearing last week. DDS assessed a sedentary residual functional capacity (RFC) for my 56-year old client, and all his past work required a substantial amount of standing and walking, which puts it in the "light" exertional category. This should be a winning claim.
However, DDS concluded that he could still perform one of his past jobs "as generally performed in the national economy." Once again, the cited DOT code was for a sedentary job with a similar name as the client's past job. But the DOT-coded job was actually quite different than the one performed by the disability claimant.
We had a short hearing. The client testified about his past work for a few minutes. The judge then asked the vocational expert (VE) at the hearing to characterize the past work, and the VE characterized all the past work as "light" or "medium" exertional jobs. So with a sedentary RFC, past work is precluded. At step 5, there were no transferable skills, so for a claimant over age 55 or older, Rule 201.06 directs a finding of disabled.
The lesson from both these successful claims is: don't forget the vocational evidence.