The Social Security Administration (SSA) recently revised the POMS and HALLEX that deal with borderline age situations for claimants seeking Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits. When adjudicators are evaluating a claim under the five-step sequential evaluation process, they must consider the claimant’s age in combination with his or her Residual Functional Capacity (RFC), education, and work experience. SSA considers advancing age to be an increase in the limiting factor in a claimant’s ability to make such an adjustment. See POMS: DI 25015.005. The important age brackets so to speak for Social Security Disability Insurance (SSDI) or SSI claims are age fifty, fifty-five, and sixty. If a claimant is within a few days or months of reaching a higher age category, and using the current age category would result in a denial, the adjudicator should consider using the higher age category if it would result in a favorable determination after evaluating all factors. 20 CFR § 404.1563 states that the ALJ must not apply the age category mechanically in a borderline situation and the case law is clear that the ALJ must at least consider applying the higher age category.
The primary clarification in POMS DI 25015.005 notes that “if a claimant is within a few days to a few months of reaching a higher age category and using the chronological age would result in a denial, consider using the higher age category if it would result in a favorable determination, after evaluating all factors…” The phrase a few days to a few months does not have a precise programmatic definition and should be interpreted by its common meaning, which is usually a small number not to exceed six months.
If you need more information about a Social Security Disability/SSI, personal injury, EEOICPA, long or short-term disability, VA disability, Railroad Retirement Board disability, or a workers compensation matter, please contact the Law Offices of Tony Farmer and John Dreiser for a free case evaluation.