What Evidence is Needed to Win a Decision based on the Grid Rules?



I recently received this question from someone who saw my video about the grid rules and asked an interesting question about what evidence he would need to prevail in a grid rule argument claim:

Here is my situation:  I am 55, with no skills, and less than a high school education (and no GED).  I have only done part time work in the past 15 years, and the last work I did was unskilled work at the medium level.  I have several problems:

  • I have traumatic brain injury, but there is no supporting medical evidence, tests or other proof
  • I have a hip and back injury
  • I have chest pains

If the grid rules say I quality for SSI based on my age, education, work history and skill level, will I still have to present medical evidence to prove that I have some or all of my health problems?

Here are my thoughts:  the grid rules do require proof of a physical impairment that causes some reduction in  your exertional capacity.  In other words, to meet one of the grid rules, you will need evidence to prove that your functional capacity has been reduced to sedentary or light work.  So you cannot simply walk into a hearing room and ask for disability based on your age, education and status as an unskilled worker.  You will have to present some medical evidence (ideally from a treating physician) that explains why your exertional capacity is now light or sedentary.  This would involve presenting medical records and test results (such as an MRI report and evaluation or a CT report and evaluation).

Further, the question of what constitutes unskilled, semi-skilled or skilled work one best answered by someone who is familiar with the Dictionary of Occupational Titles (the D.O.T.).  My point is that you may call a job "unskilled" based on the common usage of that term but there could be some element of activity in one of your past jobs that might make that job semi-skilled or even skilled, and thereby complicate the grid argument.

Finally, I always think it is wise to go into a hearing with some other argument than the grid rules.  If a listing does not apply, then perhaps a functional capacity argument might be relevant.   I would also point out that traumatic brain injury complications may be shown by physical evidence such as an MRI or CT scan, but more often than not, these injuries are documented by neuropsychological testing.   If neither type of testing shows any evidence of a brain injury, I would raise the question about whether it makes sense to bring up the assertion given that doing so could negatively impact your credibility.

If you have not already done so, I would recommend that you retain a disability lawyer.   A general information blog response is no substitute for a personal evaluation by a lawyer who can look at all of your records and offer legal advice specific to your situation.  Best of luck to you.

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Jonathan Ginsberg represents Social Security disability clients in Atlanta and throughout north Georgia

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