One often-overlooked rule in Social Security disability cases can mean the difference between approval and denial—or even add thousands of dollars in back pay to your client’s award. That rule? The “Borderline Age” regulation. You can read the actual regulation at https://secure.ssa.gov/poms.nsf/lnx/0425015006

I’ll exactly how the borderline age policy works in Social Security disability cases, why it matters, and how strategic use of this rule can significantly increase a claimant’s past due benefits. I have used the borderline age policy in several recent cases without any push back from judges and the net result meant thousands of dollars added to lump sum payments for my clients.

WATCH A SHORT VIDEO ON THE BORDERLINE AGE RULE

What Is the Borderline Age Rule?

The Borderline Age Rule comes into play when a claimant is close to aging into the next higher age category defined by the Social Security Administration (SSA). These categories are:

• Younger individual: 18–49
• Closely approaching advanced age: 50–54
• Advanced age: 55–59
• Closely approaching retirement age 60+

SSA uses these categories to determine how easily a claimant can adapt to other work, which is a critical factor in disability decisions under the Grid Rules (also known as the “Medical-Vocational Guidelines).” I publish a website explaining how the grid rules work – you can find it at https://gridrules.net.

Basically the grid rules change the definition of disability. If you are a younger (under age 50) claimant, in order to win disability benefits you have to prove that you are not capable of reliably performing any job that exists in the United States economy.

After age 50, and even more so after age 55 and especially after age 60, you don’t have to prove as much to win. At age 50 you can win even if you have the capacity to perform sit down (“sedentary”) work. At age 55 you can be found disabled even if you can perform light work.

Light work is defined by SSA as having the capacity to stand and walk for six hours or more per day and to lift 20 lbs. about 1/3 of the day. Lifting 20 lbs. for 2 hours per day is not easy – but under the Grid Rules you can still be legally “disabled” even if you have this capacity.

The grid rules are a great argument for anyone over 50 but especially those over age 55.

Not surprisingly there is a catch to using the grid rules. First you must have a physical impairment – you cannot use the grid rules for mental health issues or non-physical impairments.

Second, and this is critical – you must not have any skills that transfer to a lighter job.

The borderline age rule allows Social Security adjudicators and judges to apply the grid rules even if you have not yet celebrated a birthday that will put you into the next age category. If a person is “within a few days to a few months” of the next category, SSA does not apply the age limits strictly.

Example: How Borderline Age Can Unlock Thousands in Back Pay

Let’s say you are:

• 54 years and 7 months old at the time of onset
• Unable to perform your past relevant work
• Limited to a light residual functional capacity status due to one or more medical impairments
• Unable to use any skills you may have acquired because of distractions due to severe pain (i.e., no transferable skills)

Under a strict reading of the grid rules, you would fall within the “closely approaching advanced age” category at onset. A judge might find you disabled as of your 55th birthday but you would lose out on 5 months of past due benefits.

But if the judge applies borderline age rule and treats you as if you were age 55 then you would meet the grid rule and qualify for that extra 5 months of benefits. If your monthly payment is $2,000 per month, those extra 5 months would put another $10,000 in your pocket.

Further, the borderline age rule can keep you qualified for SSDI if your date last insured has run out. Continuing with our example from above, if your date last insured was 2 or 3 months prior to your 55th birthday, you would not meet the grids at light but applying the grids non-mechanically would mean that you could fit into the grids as of your date last insured, even before actually turning age 55.

In my experience disability adjudicators rarely invoke the borderline age rule independently. Judges sometimes do, but more often than not you have to ask. So if you are just under one of these important age categories, do not forget to argue that the borderline age rule should apply to your claim.