Steps Four and Five of the Five-Step Sequential Evaluation

Welcome to Season 1, Episode 5 of Winning Isn't Easy: Navigating Your Social Security Disability Claim. In this episode, we'll dive into the complicated topic of "Steps Four and Five of the Five-Step Sequential Evaluation."

Join host Nancy L. Cavey, a seasoned disability attorney, as she breaks down steps four and five of the five-step sequential evaluation process. In this episode, she takes an in-depth look at past relevant work (step four) and the two ways to be found disabled in step five - the GRIDS test and other work considerations. Since many claims are won or lost at these stages, understanding their impact is crucial for a successful Social Security Disability claim.

In this episode, we'll cover the following topics:

1 -  Step Four - Past Relevant Work

2 - Step Five - The Two Ways to Be Disabled (GRIDS Test or Other Work)

Whether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.


Listen to Our Sister Podcast:

We have a sister podcast - Winning Isn't Easy: Long-Term Disability ERISA Claims. Give it a listen: https://wiedisabilitypodcast.buzzsprout.com


Resources Mentioned In This Episode:

LINK TO YOUR RIGHTS TO SOCIAL SECURITY DISABILITY: https://mailchi.mp/caveylaw/your-rights-to-social-security-disability-benefits

FREE CONSULT LINK: https://caveylaw.com/contact-us/


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Need help with your Social Security Disability claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.

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Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals.

Transcript

Nancy Cavey [00:00:15]:
 Hey, I'm Nancy Cavey. I'm a Social Security disability attorney and I want to welcome you to this episode of Winning Isn't Easy. But before we get started, I have to give you a legal disclaimer. This podcast is not legal advice. The Florida Bar association says I have to say this. Now that I've said it, nothing is going to prevent me from giving you an easy to understand overview of the Social Security disability claims process, the games that can be played during your Social Security disability claim process, and what you need to know to get the disability benefits you deserve. So off we go. Now, in last week's episode, we covered how the Social Security Administration first looks at insured status and medically determinable impairments before they even get to the question of whether or not you meet the five step sequential evaluation test.
 
 Nancy Cavey [00:01:07]:
 We also discussed step three, the medical listings. Now, as I explained, most cases are decided at steps four and five of the five step sequential evaluation. And that's what we're going to focus on today. I'm going to talk about two things. I'm going to talk about step four, the past relevant work, and at step five, I'm going to talk about the two ways to meet step five, which is called the grid test or other work. Got it. Let's take a break for a moment before we get rolling into this episode.
 
 Speaker B [00:01:42]:
 Filing for Social Security disability or has your claim been denied already? Either way, you require a copy of your rights to Social Security disability benefits, which will cover every you need to know about the Social Security disability claims process. Request your free copy of the book@kvlaw.com today.
 
 Nancy Cavey [00:02:06]:
 Welcome back to Winning Isn't Easy. Let's talk about step four, past relevant work. And I think the best way to explain this is to give you an example. And I'm going to use a theoretical applicant who happens to be a housekeeper. Now, let's assume for the the basis of this discussion that she is 61 years old and she has worked as a housekeeper for the last two years and as a phone solicitor for the last three years. She has a high school education, but because of her medical conditions that she's claiming she's limited to sedentary work because of her back, knee and hip problems. So let me play devil's advocate with you. Is she entitled to her Social Security disability benefits? Well, the answer would be no because she can still do her past work as a phone solicitor.
 
 Nancy Cavey [00:03:05]:
 So what happens here in this analysis is that the Social Security Administration is going to be looking at your work history for the five years prior to the adjudication or decision on your Social Security disability claim. Now, it used to be 15 years, but they changed it to five years. One of the reasons they changed it to five years is that work has changed so much in the last 15 or 20 years that a lot of jobs simply don't exist that existed in the past, or they aren't performed the way in which they're described in the Dictionary of Occupational Titles, which is a document, huge document that the Social Security Administration uses in evaluating a person's past work and whether they can do other work in the mythical, hypothetical, not real world national economy. As a result of the changes in the 15 year period through the 5 year period, I think that it's really important that you get how significant the work history report form is. I know it's a pain in the rear end to fill out the initial application for Social Security benefits, but one of the most important forms in my view is something called the work history form. And the work history form consists of about 14 pages. That's a lot of work to complete this. But what you put on this work history form, SSA3369BK, is really important.
 
 Nancy Cavey [00:04:42]:
 And I have done another video about this for my clients that we will be talking about later. But let me quickly go through this work history form. You can see that the first part of it asks for information about you. So they want to know your name, your Social Security number, your phone number, and then they want you to listen the jobs that you've had in the five years before you became unable to work because of your medical condition, listing your most recent job forward first rather then kind of go backwards. And what they're basically asking you is what's the job title, what kind of business it was, and for what period of time you did the work. Now section two of this work history form asks you to describe the specific information about job number one. So if you've got five jobs, you will fill out section two for each of these jobs and it asks you job title one. What was your rate of pay? What were the hours that you worked days per week? Now here's what becomes important.
 
 Nancy Cavey [00:05:52]:
 It asks describe in detail the task you did in a typical workday, such as stocking shelves or greeting customers or scheduling appointments. If the task involved writing or completing reports, describe the type of reports that you did. If it involves supervising others, describe that. If it involved the use of machine tools or equipment, describe that. And if you had to do work with co workers, supervisors or the public, they want to know that. Now, what's important here, I think, is for you to think backwards. What do I mean by that? Think about the medical problems that you have that you think prevent you from working and doing your past work. Specifically, think about the problems that you have doing certain duties because you want to make sure that you are describing the tasks that you did.
 
 Nancy Cavey [00:06:45]:
 So obviously, I think you should do this on a separate piece of paper. You want to talk about, you know, did you write reports? Yes or no? And if so, what kind of reports did you do? You. You want to talk about if you supervised people, and if so, the nature of that supervision. And I want you to think about how you're going to answer the question about tools and equipment, because the workplace is full of tools and equipment. What do I mean by that? You use a computer, right? You might use a iPad, you might use your phone. You might actually, like, be a cashier and use that. Think about the equipment that you used. You also might have used a dolly to lift things or other assistive devices in moving things.
 
 Nancy Cavey [00:07:35]:
 So really think about what your job duties are in terms of what you couldn't do. Make sure that you're writing that down because you want to ultimately prove you can't do those duties. You want to talk about the equipment that you used and the supervision. Now, the next part of section 2, work history, talks about the activity, and it asks you to describe how much in a workday you stand and walk combined sit, stoop, kneel, crouch, crawl, using your fingers to mouse or keyboard, using your hands to seize something and to grasp or pinch, reaching at the shoulder level, above the shoulder level, behind you, climbing stairs or ramps, scaffolding. So think about this again. Think about what duties you have that you would have difficulty doing or having difficulty doing, and do this analysis on a separate piece of paper. Ultimately, the question also is going to be select the heaviest weight that you lifted, frequently lifted. And that's really important.
 
 Nancy Cavey [00:08:41]:
 We don't want to exaggerate. We want to be accurate about this. Because what ultimately happens at a hearing, if we get that far? Well, even not at a hearing, Social Security is going to look at this work history form and evaluate whether or not based on what they think your restrictions and limitations are, what your doctor says about your restrictions about whether you can do your past relevant work. And if you haven't described your job accurately, they're not going to be able to pick the right Dictionary of Occupational Titles code for that job, because they're going to look at that dot job description and say, well, this is a sedentary job. Based on these restrictions and based on the way you described it in the work history form, we think you can do your past relevant work. So you need to understand that you've got to think backwards. Think about the symptoms that you have and the problems that would prevent you from doing those duties. Write them down.
 
 Nancy Cavey [00:09:36]:
 Think about the equipment that you used. Think about the activities. Sitting, standing, walking, stooping, bending. Do not rush through this form because this form can make or break your claim. Got it? All right, so I will tell you that a lot of claims denials come at step four because people don't know how to fill out these forms. In our office, we do spend a lot of time with our clients discussing how to fill out this work history form. We've got an actual letter to our clients that describe it and we have a video because we want our clients to make sure that this form does not destroy their claim. Got it?
 
 Speaker B [00:10:19]:
 Let's take a break with your Social Security disability case. The right attorney can make all the difference. Get our booklet the key to hiring a great attorney for your Social Security disability case. Discover how to find and excel experienced attorney who will fight for your rights and navigate the process with ease. Don't leave your future to chance. Request your free copy@kvlaw.com today and ensure you have the expert support you deserve.
 
 Nancy Cavey [00:11:12]:
 Welcome back to Winning isn't easy. Let's talk about step five, the two ways to be disabled, the grid test or the inability to do other work. And again, what I'm going to do is I'm going to use a hypothetical applicant to illustrate the points that I want to make to you. So in this hypothetical, we're going to be dealing with an auto repair person. This gentleman is 50 years old. He does auto repair work which involves heavy lifting of equipment, including car parts, while he's making repairs. He has a high school education and he's limited to sedentary work because of a cardiac condition. Now, is he entitled to Social Security disability? What do you think? I'm going to give you a legal answer.
 
 Nancy Cavey [00:12:00]:
 Probably. Okay, well, what do I mean by probably? He can't return clearly to his past work as an auto repair person because he can't do the lifting. His doctor has restricted him from lifting in excess of 10 pounds. His doctor has said that he really can't be on his feet because of the swelling in his legs. So he's probably limited to sedentary work. The question becomes, here is okay, he can't be a car repair person. But does he have skills that he could take as a result of his employment that would transfer to other work? Now, I'm going to put this up so you can see it. This is an example of the sedentary work grids.
 
 Nancy Cavey [00:12:47]:
 When we apply the work grids, we are looking at a person's age, their education, their previous work experience, is it skilled or unskilled? And literally it will dictate the decision. So, for example, this gentleman has a high school education. So he's over 55. He is a high school graduate. His skills are not transferable. And as a result, he would grid out right here at 201.06. And simply, I went through this pretty quickly. But the key here is whether or not a person has transferable skills.
 
 Nancy Cavey [00:13:36]:
 Where in part does this analysis come from? It comes in part from that work history form that you completed. Because again, the Social Security Administration is trying to understand what your work duties are, and then they're going to measure what those work duties and skills are to determine, based on this restriction and limitation, whether you could take those skills to other work. Now, if you don't grid out, and grids are only applicable if you're over 50, the key is to prove that you can't even do a sedentary job. In the mythical hypothetical national economy, sedentary is basically described as a position in which you are sitting at least two thirds of the time and you're not lifting in excess of £10. So in our hypothetical, this gentleman probably cannot do sedentary work because he has shortness of breath. He has to take naps, he, he has swelling because of the fluid buildup. So he has to raise his feet above his heart level several times a day. And he certainly is going to be absent at least two days per month.
 
 Nancy Cavey [00:14:50]:
 So in my view, based on that set of facts, he would probably be disabled at step five. Now, I'm often asked, how does the Social Security Administration five find somebody at step five disabled using those medical vocational grids? Remember, the test is in part based on the level of your physical activity, your education, and the skills that you have learned. Now, the question, of course, is ultimately, how long can you sit? How far can you walk? How long can you stand? Do you need to alternate sitting and standing? Do you have to take breaks? How often do you have to take breaks? Importantly, do you have any problems with bilateral manual dexterity? If you have psychiatric issues, the Social Security Administration wants to understand whether you can do routine, simple, repetitive tasks, accept criticism, deal with changes in the workplace, interact with the public coworkers or supervisors and stay on task. So the Social Security administration is going to be determining your residual functional capacity. I think the best way to help them do that is to have your physician complete a residual functional capacity form for your appropriate medical condition. Now, these are forms that we Social Security lawyers have developed. Social Security is not going to tell you about them, and not all doctors know about them, which is a reason why you need to be represented by a Social Security attorney. We will provide to you the appropriate residual functional capacity form so that your doctor can complete it.
 
 Nancy Cavey [00:16:32]:
 And we can provide that to Social Security because we don't want them to kind of guess. We want them to have some medical basis for this, because ultimately, if they guess, they'll probably say you can do light work or sedentary work, which is going to result in a denial. Now, as I said, the two ways at step five to win is to meet the medical vocational guidelines grids. If you're over 50, that's like hitting bingo. Excuse me, but if you don't meet the grids or you're under 50 again, the issue is going to be whether or not you can engage in at least sedentary work and the nature of your past work to determine if there are transferable skills. More often than not, the Social Security administration, as I said, is going to default to say that you can do light work or full range of sedentary work. And again, I think the RFCs are important to convince them that based on your age, you meet the grids, or alternatively, you can't even engage in sedentary work. So let me give you another theoretical example.
 
 Nancy Cavey [00:17:49]:
 This person is a nurse. So she's been a critical care nurse for 30 years. She has long Covid with pulmonary complications, neurological complications, and fatigue issues. She's limited to sedentary work, but in the course of her past work, she's done nurse case management, which is sedentary. So is she entitled to Social Security? Well, again, the answer might be maybe, and it's clear she can't do her work at step four. But the issue is whether or not she can do her past work. Excuse me, as a case manager. So what would be important here would be developing her restrictions and limitations, particularly the COVID complications.
 
 Nancy Cavey [00:18:34]:
 Why is it that she would not be able to do case management physically or cognitively? So again, the role of the RFC is really kind of important. You can understand that if the claim is denied, you're going to appear in front of a judge and the judge is going to have a witness, a vocational evaluator who will never have met you. That vocational evaluator will be looking at that work history form you looked at to classify your past work. The judge may ask questions in the course of the hearing to develop your job duties and then say to the VE, can you classify this pass work? Mr. And Mrs. VE? So once the job has been classified, then the judge is going to come up with hypotheticals at step four and five. So what the judge may say is, I want you to assume, Mr. And Mrs.
 
 Nancy Cavey [00:19:25]:
 Ve, that there is a applicant just like the person that we talked about. She's been a critical care nurse. She has, she's 55. She has neurological complications of COVID that include problems with tingling and numbness in her lower extremities. She's got pulmonary complications, so she has shortness of breath with or without exertion. And you know, she has to take a nap at least once a day for 10 minutes. Mr. Or Mrs.
 
 Nancy Cavey [00:20:04]:
 Ve, could she be a critical care nurse? Well, the answer to that is no, because we know that the nurse position requires a lot of walking, bending, lifting. So if she can't walk because of the neurological issues or the pulmonological issues more than two hours out of eight hours, she can't be a critical care nurse. But, and that question, by the way, was step four. But the million dollar question is the next question and it would be Mr. And Mrs. Ve, in view of that hypothetical, could she to do other work? Now, based on the fact that in this example she had done case management work, the VE is going to say, oh yes, she could be a case manager. It's really crucial that you have an attorney there to represent you because the attorney at that point should be cross examining the VE and developing restrictions and limitations that would eliminate her ability to do not only that job, but other sedentary work. What are other examples of sedentary work that VEG's will come up with? As stupid as this may sound, it could be sorting nuts and bolts or pecans or peanuts.
 
 Nancy Cavey [00:21:09]:
 It could be being an addresser, addressing envelopes all day, or sitting in front of a computer, being a surveillance system monitor. So you want to make sure that the VE is cross examined. So I, for example, would add something about how the neurological complications impact her ability to do bilateral manual dexterity only on an occasional basis. I would amend probably the pulmonary complications to provide that the person's legs have to be elevated two or three times a day for 20 to 30 minutes at a time because of the medication that they're taking, they may have to urinate frequently. So there are additional unscheduled breaks that the person, because of the neurological issues, needs to be up and down, moving around, and as a result, the person is not going to be able to be on task. In fact, they're going to be off task at least 20% of the time and they're going to miss work at least two days out of a week. Obviously, when you start adding in these additional restrictions and limitations that would preclude or prevent the person from doing case management work or the stupid jobs that I just identified, it is really crucial that you are giving your doctor a complete and accurate history of your symptoms and how those symptoms impact your ability to function. So in this example, the neurological issues impact her ability to finger and that she has to get up and move around.
 
 Nancy Cavey [00:22:35]:
 The fatigue issues require her to take a nap. The pulmonary issues also result in elevating this person's legs. Ultimately, of course, it's the judge who will decide what the restrictions and limitations are, but you want to give the judge a basis for picking restrictions and limitations that are consistent with all of your disabling medical conditions. I generally don't like it for the judge to rely on the disability determination services medical evaluations or consult the physical examinations evaluations of your restrictions limitations because they'll always say that you can do light work or you can do sedentary work so you can see again, teamwork. Having a attorney who practices in the Social Security field understands all the medical problems that you have, will use residual functional capacity forms, work with you in completing this work history form, preparing you for a hearing if that's necessary, and being ready to cross examine a vocational evaluator. Now, these hearings only last about 45 minutes, so there is a lot of things that are going to happen in that 45 minutes and you need to be well prepared and your record needs to be well developed. Got it. I hope you've enjoyed this week's episode of Winning Isn't Easy.
 
 Nancy Cavey [00:23:57]:
 If you've enjoyed this episode like our page, leave a review, share it with your family or friends and of course subscribe to this podcast. Please tune in next week for another insightful episode of Winning Isn't Easy. And in next week's episode I'm going to talk about the role of your doctor in your Social Security disability claim and how they can make or break your case. Thank you.