TN 3 (08-12)

Citations:

Social Security Act - Sections 223(d)(2) and 1614(a)(3)

Regulations - 20 CFR 404.1516, 404.1520, 404.1594, 416.916, 416.920, 416.987, 416.994

A. Vocational assessment issues

The instructions in this section apply to both prototype test and non-prototype Disability Determination Services (DDSs) and to all adjudicators at each level of the administrative review process.

The prototype DDSs test possible modifications to the disability determination process pursuant to 20 CFR 404.906 and 416.1406. The instructions in this section supersede any other procedures explained in the Disability Redesign Operating Instructions. See DI 12015.100, Disability Redesign Prototype Model.

The instructions in this section apply to adult disability and disabled adult child claims under title II, adult disability claims and age 18 redeterminations under title XVI, and to determinations of whether a current adult beneficiary’s disability continues.

Consider borderline age issues prior to expediting the vocational assessment at Step 5. See DI 25015.006E.2. Borderline Age — Determine whether the overall impact of the factors justifies using the higher age category to find the claimant disabled.

The instructions in this section do not change our rules for determining whether a claimant is disabled.

B. Adjudicator actions for steps 1 – 3 of sequential evaluation

Develop the medical and vocational evidence and evaluate the claim from steps 1 through 3 of sequential evaluation using current guidelines.

C. Adjudicator actions for step 4 of sequential evaluation

At this step of the sequential evaluation process, make a finding of fact about the claimant’s residual functional capacity (RFC) to perform the work-related physical and mental demands of past relevant work (PRW). Consider whether the claimant can meet the demands of PRW as the claimant actually performed it or as generally performed in the national economy.

1. When vocational evidence is sufficient to evaluate PRW at step 4

If the vocational evidence is sufficient to find that the claimant can perform one past relevant job as the claimant actually performed it, or as generally performed in the national economy, deny the claim at step 4; do no further vocational development.

2. When vocational evidence is not sufficient to evaluate PRW at step 4

If the vocational evidence is not sufficient to find whether the claimant is able to perform PRW, you may proceed with one of the two following options.

1. Develop the vocational evidence according to procedures in the following instructions.

   • DI 22515.001 General - Development of Vocational Evidence

   • DI 22515.005 Use of Form SSA-3369-BK (Work History Report)

2. Proceed directly to step 5.

NOTE:

• Do not deny a claim for refusal or failure to cooperate at step 4 before considering whether the claimant can adjust to any other work at step 5.

• Before proceeding to step 5, consider whether any of the special medical-vocational profiles explained in DI 25010.001 Special Medical-Vocational Profiles might be applicable. If any of the profiles might apply, you cannot use this expedient.

D. Adjudicator actions for step 5 of sequential evaluation

Consider whether the claimant can adjust to any other work that exists in significant numbers in the national economy, based solely on the claimant's age, education, and RFC.

If the claimant’s insufficient work history precludes the identification of PRW skill level and transferability, you will not be able to identify the specific rule from the medical-vocational guidelines that applies. See DI 25025.005 Exhibit of Appendix 2 - Medical-Vocational Guidelines.

NOTE: In some cases, you do not need PRW skill level and transferability information because the claimant’s age, education, and RFC always lead to a determination of not disabled regardless of skill level and transferability factors.

EXAMPLE: Under Rules 201.27, 201.28, and 201.29 of the medical-vocational guidelines, you will find a 44-year-old claimant with a high school education and a sedentary RFC not disabled regardless of the claimant's PRW skill level or transferability of those skills.

1. When vocational evidence supports an allowance at step 5

If you did not make a finding at step 4 and any of the potentially applicable special medical-vocational profiles or medical-vocational guidelines indicates a determination of disabled, take the following actions:

1. DO NOT allow the claim at step 5. The Social Security Act requires you to develop a claimant’s relevant work history and make a finding of fact at step 4 before you can determine that a claimant is disabled.

2. After returning to step 4, follow all required procedures to develop the claimant’s PRW.

   • If the claimant does not provide the requested information and you do not have sufficient evidence to make a finding at step 4, follow the refusal to cooperate determination instructions or the failure to cooperate determination instructions, as appropriate.

   • If the claimant provides the information needed to make a finding at step 4 or you obtain sufficient evidence to make a determination without the claimant’s cooperation, make a disability determination based on the evidence in file.

References:

• DI 25010.001 Special Medical-Vocational Profiles

• DI 25025.005 Exhibit of Appendix 2 - Medical-Vocational Guidelines

• DI 22515.030 Use of Form SSA-3369-BK (Work History Report)

• DI 23007.004 Refusal to Cooperate With Requests to the Claimant for Evidence or Action

• DI 23007.005 Failure to Cooperate With Requests to the Claimant for Evidence or Action

2. When vocational evidence supports a denial at step 5

If all the potentially applicable medical-vocational guidelines indicate a determination of not disabled based solely on the claimant's age, education, and RFC, take the following action.

1. Deny the claim. If you do not consider previous work experience, the step 5 denial will always be a framework determination. See Application of Medical-Vocational Rules DI 25025.001.

2. Select the lowest potentially applicable numbered rule to use as a framework for your determination.

   EXAMPLE: Use Rule 201.21 for a 46-year-old claimant with a high school education and a sedentary RFC or Rule 202.20 if this claimant has a light RFC.

   NOTE: If the claimant has solely a non-exertional limitation(s), use Rule 204.00 as a framework, see DI 25025.001B.1.

3. If applicable, include the following statement in the vocational assessment: “A finding about the capacity for PRW has not been made. However, this information is not material because all potentially applicable medical-vocational guidelines would direct a finding of “not disabled,” given the claimant’s age, education, and RFC. Therefore, the claimant can adjust to other work."

4. Cite either:

   • three specific occupations that exist in significant numbers in the national economy that the claimant has the ability to perform with an affirmative statement acknowledging that such jobs exist in significant numbers in the national economy; or

   • the Social Security Ruling that supports the finding that the claimant’s occupational base is not significantly eroded.

5. Comply with current rules regarding the content of the personalized disability explanation (PDE) and, when necessary, include the following statement in the PDE:

   "We do not have sufficient vocational information to determine whether you can perform any of your past relevant work. However, based on the evidence in file, we have determined that you can adjust to other work." For additional PDE instructions, see DI 26530.020 – Personalized Disability Explanation in Initial Denials.