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Unlock Thousands in Social Security Disability Back-Pay with the Borderline Age Rule

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. Continue reading →

How Does a Social Security Judge Decide if I have “Transferable Skills” for Grid Rule Purposes?

transferable skillsThis is a good question – the short answer is that judges will look to vocational expert witness testimony to determine whether a claimant has acquired transferable skills.

Your question got me thinking that it might be helpful to review how the grid rules work and to take my readers through a grid rule analysis, so, here you go:

The grid rules, or “medical vocational guidelines” can qualify you for Social Security disability benefits even if you have some capacity to work, but you are not likely to find work because of limited skills and a limited education.

In order to qualify for a finding of disability under the grid rules you must have exertional limitations. This means that your medical issues must impact your physical capacity. Thus, a person asserting disability based on depression, or bi-polar disorder, or schizophrenia could never qualify under the grid rules [1. Such a person could, however, qualify for disability based on a listing or using a functional capacity argument.]

You can look at the grid rules here.

The grid rules look at several factors: your age, your education, the skill level of your past work and whether or not your past work generated any transferrable skills. SSA lays out these factors in a table divided by grid lines – thus the name.

When a judge applies the grid rules he first must make a decision about your capacity for work. If you are limited to sedentary work, you are more likely to be found disabled under the grid rules than if you are limited to light or medium work.

Let’s analyze how the grid rules work in practice. Continue reading →

How Does a Social Security Judge Decide if I have "Transferable Skills" for Grid Rule Purposes?

transferable skillsThis is a good question – the short answer is that judges will look to vocational expert witness testimony to determine whether a claimant has acquired transferable skills.

Your question got me thinking that it might be helpful to review how the grid rules work and to take my readers through a grid rule analysis, so, here you go:

The grid rules, or “medical vocational guidelines” can qualify you for Social Security disability benefits even if you have some capacity to work, but you are not likely to find work because of limited skills and a limited education.

In order to qualify for a finding of disability under the grid rules you must have exertional limitations. This means that your medical issues must impact your physical capacity. Thus, a person asserting disability based on depression, or bi-polar disorder, or schizophrenia could never qualify under the grid rules [1. Such a person could, however, qualify for disability based on a listing or using a functional capacity argument.]

You can look at the grid rules here.

The grid rules look at several factors: your age, your education, the skill level of your past work and whether or not your past work generated any transferrable skills. SSA lays out these factors in a table divided by grid lines – thus the name.

When a judge applies the grid rules he first must make a decision about your capacity for work. If you are limited to sedentary work, you are more likely to be found disabled under the grid rules than if you are limited to light or medium work.

Let’s analyze how the grid rules work in practice. Continue reading →

Onset Dates, Consultative Exams and Cynical Judges

When you appear before a Social Security judge for a hearing, there are four possible outcomes:

  1. you will be approved
  2. you will be denied
  3. your case will be continued to another date for a supplemental hearing
  4. the judge will issue a “partially favorable” decision

GavelOver the past couple of years I have noticed an increase in the number of partially favorable decisions I am receiving.  I think this is because my clients, especially low income clients, do not have access to regular medical care and judges are using consultative exam reports to move the alleged onset dates.

Here is an example of what I mean:  a couple of weeks ago, I tried a case before a judge who is generally considered to be very reluctant to approve cases.  At the time of the hearing my client was a month shy of her 52nd birthday.  She had a 10th grade education and past work as a short order cook.  She alleged disability due to uncontrolled diabetes, numbness in her feet and hands, vision issues and pain.

She last worked 3 years previously, when she was 48 years old.

In reviewing this case, I saw it as a “grid rule” case.   Grid rule 201.10 provides that a 50 year old claimant with less than a high school education, semi-skilled work but no transferable skills who was limited to sedentary work due to an exertional limitation would qualify for disability. Continue reading →

57 Year Old Arthritis Patient Wonders if She Would Qualify for Disability

I am 57 I have been a RN for the past 30 yrs.  I have auto immune arthritis which is severe in my SI joints graded 3+ bilaterally.  I also arthritis in my hands, wrist, elbows, shoulders, knees, feet and ankles.  Along with DMII, IBS, Bilateral Carpal Tunnel, Bilateral Heel Spurs. My dominant hand is now becoming weak and painful to the point, I am having to learn how to redo ADL’s with my non dominant hand.  I can’t sit, stand or lay or long periods of time, I rarely sleep more than 3 hours at a time due to numbness or pain in a joint. I just recently stopped working.

Where would I fit on the Grid, or do I have to suck up the pain and continue to try and work. I only have enough reserves to last me 7-8 months. Thanks for your opinion.
–C

Jonathan Ginsberg responds:  C, thank you for your question.  I am not so sure that the grids would apply here.  Firstly the grids only apply when there is an exertional (physical) impairment.  Here you have both exertional and non-exertional (pain) impairments.   It would appear to me that pain is such a major part of your claim that you could not argue that your limitations are purely exertional.

Second, and most important, the grids factor in education and transferrable skills.  Look at the grid tables.  Even at age 57, an individual limited to sedentary (sit down) work is “not disabled” if she has transferrable skills or more than a high school education.

I think that a better argument would be a straight “residual functional capacity” argument.  Please also take a look at my Arthritis and Disability article on my Georgia Social Security disability web site.  I would focus on reliability issues and limited capacity to get through a workday in any form of competitive employment.

Your 30 year work history also gives you tremendous credibility.  You always want to approach your SSDI claim with the attitude that “I would work if I could, but I can’t” and not an attitude of “entitlement.”

Based on what you write, it appears to me that you have a good case.  You need to enlist your treating doctors for support but I would be surprised if you did not get approved.

What are the “Grid” Rules and Where Can I Find Them?

Jonathan, what are the grid rules you mentioned? (why is your case easier to win if you are over 50)?
–Janet

Jonathan Ginsberg responds: The “grids” are rules that can make it easier for you to be found disabled. Social Security recognizes that if you are over 50, have a limited education and have limited job skills, you will have a more difficult time re-entering the work force. Job possibilities become even harder at 55 and even more so at 60.

If you put these factors (age, education ,transferability of skills, work capacity) into a table, you can construct a grid of intersecting boxes.  Thus – the “grids.”  The official name for the grids is the “medical vocational guidelines.”

Under the grids, you can be found disabled even if you can still perform certain types of work. By contrast, cliamants under the age of 50 generally would not be found disabled if they could do any work.

The grids are a series of tables that consider these factors. You can look at the grids by clicking on the link.

Example: Under grid rule 201.04, a 55 year old individual who can perform sedentary (sit down) work who is a high school graduate, with an unskilled work background and who does not have the skills to perform semi-skilled or skilled work would be found disabled under the grids.

Note that the grid rules only apply if your medical condition limits your physical capacity for work.  You cannot “grid out” for a mental health problem.

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