December 10, 2018

The Grid Strategy

Applying the Grid Rules in a Lupus Case

When you apply for Social Security Disability benefits, there are different approaches that can be utilized to ensure a favorable outcome. One of these approaches is the use of the Grid Rules. The purpose of the Grid Rules is to provide medical-vocational guidelines in order to focus more on the age, education and work background of the individual in relation to how the disease impacts and limits one’s capacity to function in daily life, both at home and at work.

The Grid Rules differentiate one’s physical capacity to work into three different categories: sedentary, light and medium. Restriction for lifting, sitting, and standing placed by one’s physician give credence to one’s claim of limited functional capacity. The degree of limitation is determined by the Grid Rules.

There are some limitations to the use of Grid Rules. The Grid Rules generally apply to those who are age 50 and older. For those who are below the age of 50, a partially favorable decision can be awarded based on the Grid Rules. In addition, medical conditions that limit one’s physical capacity to work qualify under the Grid Rules; mental health problems do not qualify for awarding benefits under the Grid Rules.

For example, lupus is a medical condition that limits one’s physical capacity to function in daily life. Lupus is an autoimmune disease, meaning the body’s immune system attacks healthy cells and tissues in the body, therefore attacking many body organ systems. Some of the physical symptoms associated with lupus include fatigue; joint pain, stiffness and swelling; shortness of breath; and chest pain. In addition to these symptoms, other complications within the body occur as a result of the disease process associated with lupus, including kidney damage, dizziness, and seizures.

When applying the Grid Rules to a case where the claimant’s lupus symptoms interfere with his or her physical capacity to work, the age, education and previous work experience are considered. The following are combinations of these three criteria which may qualify a claimant for disability benefits as set forth by the Grid Rules:

Grid Rule Age Education Work Experience
201.01 (Sedentary) 55+ Limited/less Unskilled/none
201.02 (Sedentary) 55+ Limited/less Skilled/semi-skilled (non-transferrable skills)
201.04 (Sedentary) 55+ High School graduate or more Unskilled/none
201.06 (Sedentary) 55+ High School Graduate or more Skilled/semi-skilled (non-transferrable skill)
201.09 (Sedentary) 50-54 Limited/less Unskilled/none
201.10 (Sedentary) 50-54 Limited/Less Skilled/semi-skilled (non-transferrable skill)
201.12 (Sedentary) 50-54 High School graduate or more Unskilled/none
201.14 (Sedentary) 50-54 High School Graduate or more Skilled/semi-skilled (non-transferrable skill)
201.17 (Sedentary) 45-49 Illiterate/unable to communicate in English Unskilled/non
202.01 (Light) 55+ Limited/less Unskilled/none
202.02 (Light) 55+ Limited/less Skilled/semi-skilled (non-transferrable skill)
202.04 (Light) 55+ High School Graduate or more Unskilled/none
202.06 (Light) 55+ High School Graduate or more Skilled/semi-skilled (non-transferrable skill)
202.09 (Light) 50-54 Illiterate/unable to communicate in English Unskilled/none
203.01 (Medium) 60-64 Marginal/none Unskilled/none
203.02 (Medium) 60-64 Limited/less None

Remember that medical records and employment records are important documents to present as evidence when making your case for qualifying under the Grid Rules. The medical records will show, from your physician’s expert perspective, what your fundamental physical limitations are based on your disease process and his examinations, as well as the treatments of the disease and their effect on your ability to work. The employment records will show how these physical limitations translate into the inability to perform the work based on the job description and the qualifications necessary to perform the job, including lifting, sitting and standing requirements.