Claims E.S.P.

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   Ex Disability Examiner Reveals How to Get an Accurate Decision in the Least Amount of Time!  

 

9 Steps Disability Guide
 

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An Example of Using the Med-Voc GRID Chart to Reach a Claim Decision

 

So let’s take a pretend case scenario to try to explain what happens.

You, as claimant, come in with “failed back surgery syndrome” -- yes, there have been so many of them that this condition actually has a name. You claim the pain prevents you from driving your truck long distance as was required in your last job. You have been a long distance truck driver for the past 30 years.  You have a HS GED and you just turned 53 years old.

I, as disability examiner, receive the case and the first thing I do after noting your age, educational level and guessing the skill level of the work you did, try to determine what physical exertional level of work that I must get you “down to” in order to allow your claim using the GRID rules, or the Med-Voc rules.

I look at the work history information you gave to try to determine what exertional level you say you did on your last job. You tell me you did not do any lifting on your job, that all you had to do was drive the 18-wheeler tractor trailer to the destination, fill out some paper work and let someone else unload the cargo for you.

As an experienced claims examiner, I do not believe your exertional level is “Sedentary” which is what you infer when you tell me you did no lifting on your job. So even though you sat down for a lot of the eight hours on the job, I decide I had better look up your job in the Dictionary of Occupational Titles (DOT) for a more accurate work exertional level.

I do this and see that your job is classified as “medium level” work, and is considered “semi-skilled” work. For the purposes of this example, I use this job description as noted  from the DOT listing below.

 

CODE: 906.683-022
TITLE(s):TRUCK DRIVER, LIGHT (any industry)


Drives truck with capacity under 3 tons to transport materials in liquid or packaged form and personnel to and from specified destinations, such as railroad stations, plants, residences, offices, or within industrial yards: Verifies load against shipping papers. Drives truck to destination, applying knowledge of commercial driving regulations and roads in area. Prepares receipts for load picked up. Collects payment for goods delivered and for delivery charges. May maintain truck log according to state and federal regulations. May maintain telephone or radio contact with supervisor to receive delivery instructions. May drive truck equipped with public address system through city streets to broadcast announcements over system for advertising or publicity purposes. May load and unload truck. May inspect truck equipment and supplies, such as tires, lights, brakes, gas, oil, and water. May perform emergency roadside repairs, such as changing tires, installing light bulbs, fuses, tire chains, and spark plugs. May be known in establishment according to type of activity as Crew-Truck Driver (any industry); Insect Sprayer, Mobile Unit (government ser.); Mail-Truck Driver (any industry); Motor-Vehicle-Escort Driver (business ser.); Pick-Up Driver (motor trans.); Service-Parts Driver (automotive ser.); Sprinkler-Truck Driver (any industry).
---------------------------------------------------------------------------------

GOE: 05.08.01 STRENGTH: M GED: R3 M2 L2 SVP: 3 DLU: 87



The DOT has little codes at the bottom of the description that tell me other things about your occupation. This last line:

 

GOE: 05.08.01 STRENGTH: M GED: R3 M2 L2 SVP: 3 DLU: 87

 

tells me that the strength of the job was “M” for medium level work (i.e. exerting 25 to 50 pounds of force occasionally, and/or 10 to 20 pounds of force frequently).

The SVP (Specific Vocational Preparation) code of 3 tells me the work is considered semi-skilled work. [For more detailed information on the codes, see our article resource directory at the end of this page.]

So using this additional DOT information, I then consult the GRID rules and look under your appropriate age category as well as the exertional level I need to get you down to. In this case it is light work, which is one step down from medium level work.

If you are 50 or over, the examiner will always try to get you down at least one exertional level because it will be much easier to get a “disabled” finding on your claim if you can not do the exertional requirements of your past job(s).

This means I will be checking your medical records as they come in and hoping that they will show you can no longer do your past work exertional level. Because if you are 50 or over, even if you are found to be able to do the next exertional level, i.e. you go from being able to do medium level work to now only being able to do light level work because of your disability, then I have a good chance at being able to allow your claim based on what the GRID rules dictate.

In this example, I like Grid Rule 202.06 as a starting point because I know if your medical records indicate you are no longer capable of medium level exertion on your job, this rule found under the “Light Level” rules may allow me to approve your claim.

It may sound complicated, but in effect, because you are at least 50 years of age, I am simply looking at your past work exertional requirement of “Medium” and looking at the next level down, “Light”, to see which rule I will use to allow your claim in the event that your medical records show that you can now only do light work.

Next... How to Read the Grid Chart

 
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