Current through Register 1531, September 27, 2024
(A)
Basic Work Activity.
(1) If the Department's agent determines that
an applicant or client does not have an impairment or combination of
impairments that either meets or is equivalent to a medical standard specified
in
106 CMR
703.192, or an impairment that is included in
the SSI Listing of Impairments as specified in
106 CMR
703.191(A)(1)(b), the agent
shall determine if the applicant or client has an anatomical, physiological, or
psychological (or combination thereof) impairment(s) that:
(a) is documented by medically acceptable
clinical and/or laboratory diagnostic techniques;
(b) is expected to last for at least 30 days;
and
(c) has more than a nominal
effect on the applicant's or client's physical and/or mental capacity to
perform on a sustained basis one or more basic work activities.
(2) If the applicant or client has
an impairment, or combination of impairments, that meets the requirements of
106 CMR 703.193(A)(1) and the impairment is a physical impairment, as defined
in 106 CMR 703.193(B)(5), the Department's agent shall use the vocational
factors specified in 106 CMR 703.193(C) to determine if the applicant or client
has an impairment or combination of impairments that substantially reduces or
eliminates the applicant's or client's ability to support himself or herself
for purposes of
106 CMR
703.191(A). If the
impairment is a mental impairment as defined in 106 CMR 703.193(B)(4), the
agent shall use the vocational factors specified in 106 CMR 703.193(D) to
determine if the applicant or client has an impairment or combination of
impairments that substantially reduces or eliminates the applicant's or
client's ability to support himself or herself for purposes of
106 CMR
703.191(A).
(3) If an applicant or client does not have
an impairment, or combination of impairments, that meets the requirements of
106 CMR 703.193(A)(1), the applicant or client shall not be considered as
having an impairment or combination of impairments that substantially reduces
or eliminates the applicant's or client's ability to support himself or herself
for purposes of
106 CMR
703.191(A).
(4) If the applicant or client has more than
one impairment, the Department's agent shall determine if the impairments in
combination with each other satisfy the requirements of 106 CMR
703.193(A)(1).
(5) For purposes of
106 CMR 703.193(A)(1), basic work activities mean those activities that are
required to do most jobs. Basic work activities include walking, standing,
sitting, lifting, pushing, pulling, reaching, seeing, hearing, speaking,
understanding, carrying out and remembering simple instructions, use of
judgment, responding appropriately to supervision and coworkers, and dealing
with changes in a routine work setting.
(B)
Definitions. The
following definitions shall apply to 106 CMR 703.193.
(1)
Direct entry
means a person has the education and/or vocational training or past work
experience to enter a job without further formal training beyond basic
orientation.
(2)
Education means formal schooling, other training,
and/or work experience which contributes to an ability to meet an educational
requirement for a job; for example, reasoning ability, communication skills,
and arithmetic ability.
(3)
Illiterate means an inability to read and write a
simple message such as instructions or inventory lists even if the individual
can sign his or her own name.
(4)
Mental Impairment means a psychological impairment
documented by medically acceptable clinical and/or laboratory diagnostic
techniques.
(5)
Physical Impairment means an anatomical or
physiological impairment or combination of anatomical and/or physiological
impairments documented by medically acceptable clinical and/or laboratory
diagnostic techniques.
(6)
Previous Work Experience means work experience which
occurred within the past five years.
(7)
Sedentary Work
means work activity that may involve occasional lifting, but no more than ten
pounds at a time, (
i.e., carrying articles like docket files,
ledgers and small tools) and frequently (from 1/3 to 2/3 of the time) may
require an individual to exert a negligible amount of force by lifting,
carrying, pushing, pulling or otherwise moving objects.
Sedentary work involves walking and/or standing a minimum of
two hours per day and sitting up to six hours per day with normal
breaks.
(8)
Semi-skilled means work requiring some skills but does
not require doing more complex job duties; may require alertness and attention
to watching machine processes; inspecting, testing or looking for
irregularities; tending or guarding equipment, property or persons; requiring
dexterity and coordination.
(9)
Skilled means work requiring judgment to determine the
machine and manual operations to be performed in order to obtain the proper
form, quality or quantity of material to be produced; may require laying out
work, estimating quality, determining suitability and quantity of materials;
making precise measurements; dealing with people, facts or figures or abstract
ideas at a high level of complexity.
(10)
Transferable
Skills means skilled or semi-skilled work activities that were
done in past work and can be used to meet the requirements of skilled or
semi-skilled work activities of other jobs or kinds of work.
(11)
Unable to Communicate in
English means the inability to understand English and give simple
oral or written instructions in English.
(12)
Unskilled means
work requiring little or no judgment to do simple duties that can be learned by
rote or by demonstration on the job in a short period of time; it may or may
not require considerable strength; a person can usually learn to do the job in
30 days and little specific vocational preparation and judgment are
needed.
(C)
Physical Impairment.
(1) An applicant or client who has a physical
impairment as defined in 106 CMR 703.193(B)(5) that meets the requirements of
106 CMR 703.193(A)(1) shall be considered as having an impairment or
combination of impairments that substantially reduces or eliminates the
applicant's or client's ability to support himself or herself for purposes of
106 CMR
703.191(A), if:
(a) he or she cannot do the full range of
sedentary work;
(b) he or she can
do the full range of sedentary work but not more and is determined disabled
under 106 CMR 703.193(C)(4); or
(c)
he or she can do more than the full range of sedentary work and is determined
disabled under 106 CMR 703.193(C)(6).
(2) If an applicant or client has both a
physical and a mental impairment, the Department's agent shall first determine
if based on the applicant's or client's physical impairment alone he or she has
an impairment that substantially reduces or eliminates the applicant's or
client's ability to support himself or herself pursuant to 106 CMR 703.193(C).
If the applicant or client is determined not to have such a physical
impairment, the agent shall proceed to make the determination required by 106
CMR 703.193(D) for mental impairments.
(3) The determination of whether or not an
applicant or client can do the full range of sedentary work or more will be
made solely on the applicant's or client's functional capacity. In determining
an applicant's or client's functional capacity, the Department's agent shall
consider if the statements of the competent medical authority
(see
106 CMR
701.600: Definition of Tems)
are consistent with the diagnoses, clinical findings and the statements of the
applicant or client, including statements as to symptoms as set forth in
106 CMR
703.192(O).
(4) If an applicant or client can do the full
range of sedentary work but not more, the grid specified in 106 CMR
703.193(C)(5) shall be used in determining if an applicant or client is or is
not disabled for purposes of
106 CMR
703.191(A).
(5)
Grid.
|
Age |
Education |
Previous Work Experience |
Decision |
|
55 or older |
Illiterate or unable to communicate in
English |
Unskilled or none |
Disabled |
|
55 or older |
Less than 12th grade - at
least literate |
Unskilled or none |
Disabled |
|
55 or older |
Less than 12th
grade |
Skilled or semiskilled - skills not
transferable |
Disabled |
|
55 or older |
Less than 12th
grade |
Skilled or semiskilled - skills
transferable |
Not Disabled |
|
55 or older |
High school graduate or more - does not provide for
direct entry into skilled work |
Unskilled or none |
Disabled |
|
55 or older |
High school graduate or more - provided for direct
entry into skilled work |
Unskilled or none |
Not Disabled |
|
55 or older |
High school graduate or more - does not provide for
direct entry into skilled work |
Skilled or semiskilled - skills not
transferable |
Disabled |
|
55 or older |
High school graduate or more - does not provide for
direct entry into skilled work |
Skilled or semiskilled - skills not
transferable |
Not Disabled |
|
50 - 54 |
Illiterate or unable to communicate in
English |
Unskilled or none |
Disabled |
|
50 - 54 |
Less than 12th grade - at
least literate |
Unskilled or none |
Disabled |
|
50 - 54 |
Less than 12th
grade |
Skilled or semiskilled - skills not
transferable |
Disabled |
|
50 - 54 |
Less than 12th
grade |
Skilled or semiskilled - skills
transferable |
Not Disabled |
|
50 - 54 |
High school graduate or more - does not provide for
direct entry into skilled work |
Unskilled or none |
Disabled |
|
50 - 54 |
High school graduate or more - provided for direct
entry into skilled work |
Unskilled or none |
Not Disabled |
|
50 - 54 |
High school graduate or more - does not provide for
direct entry into skilled work |
Skilled or semiskilled - skills not
transferable |
Disabled |
|
50 - 54 |
High school graduate or more - does not provide for
direct entry into skilled work |
Skilled or semiskilled - skills not
transferable |
Not Disabled |
|
Younger Individual Age 45-49 |
Illiterate or unable to communicate in
English |
Unskilled or none |
Disabled |
|
Age 45- 49 |
Less than 12th grade - at
least literate |
Unskilled or none |
Not Disabled |
|
Age 45- 49 |
Less than 12th
grade |
Skilled or semiskilled - skills not
transferable |
Not Disabled |
|
Age 45- 49 |
Less than 12th
grade |
Skilled or semiskilled - skills
transferable |
Not Disabled |
|
Age 45- 49 |
High school graduate or more |
Unskilled or none |
Not Disabled |
|
Age 45- 49 |
High school graduate or more |
Skilled or semiskilled - skills not
transferable |
Not Disabled |
|
Age 45- 49 |
High school graduate or more |
Skilled or semiskilled - skills not
transferable |
Not Disabled |
|
Younger Individual Age 18 - 44 |
Illiterate or unable to communicate in
English |
Unskilled or none |
Not Disabled |
|
Age 18 - 44 |
Less than 12th grade - at
least literate |
Unskilled or none |
Not Disabled |
|
Age 18 - 44 |
Less than 12th
grade |
Skilled or semiskilled - skills not
transferable |
Not Disabled |
|
Age 18 - 44 |
Less than 12th
grade |
Skilled or semiskilled - skills not
transferable |
Not Disabled |
|
Age 18 - 44 |
High school graduate or more |
Unskilled or none |
Not Disabled |
|
Age 18 - 44 |
High school graduate or more |
Skilled or semiskilled - skills not
transferable |
Not Disabled |
|
Age 18 - 44 |
High school graduate or more |
Skilled or semiskilled - skills not
transferable |
Not Disabled |
(6) If
an applicant or client can do more than the full range of sedentary work, the
vocational factors as set forth in the grid at 106 CMR 703.193(C)(5) shall be
applied to the applicant or client. If under the grid, the applicant or client
is determined to be "not disabled," the applicant or client shall not be
considered disabled for purposes of
106 CMR
703.191(A).
In all other cases, the Department's agent shall do a further
review, based on the applicant's or client's functional capacity and the
factors set forth in this section, to determine if there is a significant
amount of full-time work in the northeast regional economy that the applicant
or client could do. If a significant amount of such full-time work does not
exist, the applicant or client shall be considered disabled for purposes of
106 CMR
703.191(A). The vocational
factors that are to be considered in this further review are as follows:
(a)
Physical
Activity.
1. the kinds and
amount of physical activity the applicant or client can perform with his or her
impairment(s) on a regular and sustained basis;
2. whether such physical activity is
consistent with the applicant's or client's physical impairment(s);
3 the kinds and amount of non-exertional
limitations on the applicant's or client's physical activity, including, but
not limited to, vision, hearing, speaking, posture, reaching and feeling;
and
4 the possible effects, if any,
the applicant's or client's medications may have on his or her work
capacity.
(b)
Age. The extent to which the applicant's or client's
age may affect his or her ability to adjust to changes in work routine or work
environment.
(c)
Education/Vocational Skills.
1 the years of formal education, if any, that
the applicant or client has completed;
2. training and past work experience of the
applicant or client;
3. whether the
applicant or client has transferable skills;
4. if the applicant or client is literate and
able to communicate in English; and
5. the period of time that has lapsed between
the applicant's or recipient client's education, training or past work
experience and the beginning of his or her impairments.
(d)
Work in the Regional
Economy.
1. For purposes of
determining the amount of full-time work that exists in the northeast regional
economy of the United States within the range of work ("sedentary". "light".
"medium". "heavy" and "very heavy" as those terms are defined in the Dictionary
of Occupational Titles) that the applicant or client can perform, the
Department's agent may rely on the Dictionary of Occupational Titles,
Occupational Outlook Handbook and Labor Market Surveys.
2. A significant amount of such work exists
in the north-east regional economy if there is a significant number of
full-time jobs in one or more occupations that the applicant or client could do
with his or her functional capacity and vocational qualifications. It is not
necessary for such work to exist in the immediate area where the applicant or
client lives; for job vacancies to exist; or for the applicant or client to be
hired if he or she applied for such work.
(D)
Mental
Impairment. For an applicant or client who has a mental impairment
as defined in 106 CMR 703.193(B)(4), including the combination of mental and
physical impairments, the Department's agent shall consider in combination with
the applicant's or client's functional capacity the factors specified in 106
CMR 703.193(C)(6) and the following factors in determining whether there is a
significant amount of full-time work in the northeast regional economy that the
applicant or client could do. If a significant amount of such full-time work
does not exist, the applicant or client shall be considered disabled for
purposes of
106 CMR
703.191(A). The factors are:
(1) whether there is any impairment to
memory, concentration, pace and persistence, social functioning, independence,
and anhedonia;
(2) whether the
applicant's or client's medication may have side effects that may limit those
abilities specified in 106 CMR 703.193(D)(1);
(3) the applicant's or client's ability to:
(a) understand, remember and carry out simple
instructions;
(b) make simple
work-related decisions;
(c) accept
supervision and to ask questions or request assistance;
(d) complete tasks in a timely manner;
and
(e) adjust to changes in work
routine or work environment; and
(4) the applicant's or client's past work
experience.
