Horror Escape Room

VOCATIONAL RESOURCE CADRE'S

HALLOWEEN Escape room

START

Introduction

The facts of this case are not all that spooky but it's Halloween-time. You must navigate the house to discover the keys to this case and help the claimant complete her disability claim. This is your key to escape.

Enter the house

Background

The claimant is age 56 on the alleged onset date (AOD). She filed concurrent applications. Her date last insured (DLI) is in the future. She alleges disability due to: chronic venous insufficiency, stents in both legs, and deep vein thrombosis (DVT).

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Explore the house

Inventory

Your review of the MER shows support for the claimant's reports of significant difficulties. You think you are looking at a potential allowance. What do you do next?

See if the MC sees support for a Step 3 allowance

See if the MC sees support for an inability to sustain

Get clarification of the claimant's past work to determine how best to proceed

CONTINUE

The claimant reports past work booking timeshare tours which involved sitting 6.5 hours per day. However, in her 3369 she also reports standing and walking 6.5 hours a day, What should you do?

Assume the claimant worked 13 hours a day

Ask the claimant how many hours a day she worked.

Assume the job is light since she stood and walked as much as she sat.

The claimant reports she worked 6.5 hours a day.

Continue

Which of the following is definitely true?

The claimant's past work is sedentary.

We need more information concerning the past work.

The claimant's past work is light

We need to consult the DOT to clarify the past work.

If the claimant's work was part-time can it be PRW?

NO

YES

You found a secret message!

SGA

We need to know whether the work was performed at SGA to help clarify whether it's past relevant work. Remember these letters and play them on the piano in the correct order

...Keep playing

...One more

Start over...

You found a new item for your inventory

Is the claimant's past work PRW? Use the magnifying glass to search for the answer

YES

Find the key to continue

This is not correct...

Call the claimant

Given what we know so far, it is KEY to clarify the claimant's PRW....

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Inventory

Continue

You need more information about how the claimant performed her past work. Let's ask her some questions...

What tools did she use?

Was there a certain amount of time she was on the phone?

Was she able to stand up while on the phone?

CLICK TO UNSCRAMBLE

ITYILBFEXIL IIATLINOMT VEELTEA

Unscramble the words...

FLEXIBILITY LIMITATION ELEVATE

Unscramble the words...

The claimant reported flexibility in taking breaks to stand and walk when needed. She was able to elevate her legs while working. Which additional limitation might enable the RFC to allow?

Two 15 minute breaks

None of these

Sit-stand at will

Need to elevate legs

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Inventory

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Which RFC will allow?

Sedentary, but sit no more than 5 hours during the day.

Sedentary plus elevate legs during workday above heart level.

Sedentary but sit no more than 4 hours during the day.

The only RFC that will allow is an inability to sustain

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It's locked...look in the inventory for something to open it

Click to see explanation

Congratulations

You solved the case. You escaped the house and helped complete the claimant's disability claim.

The claimant's PRW is sedentary per the DOT. She performed it part-time but had to sit at least 4 hours and 15 minutes during the workday. If claimant is limited to sitting 4 hours during the workday she cannot perform her PRW as generally or actually performed. There is no possibility that skills would transfer to other sedentary occupations given this limitation. A finding of disabled is warranted under framework of Medical-Vocationl Rule 201.06.

POMS DI 250005.020E If the claimant can do PRW as generally performed in the national economy (usually an eight-hour day and a five-day week), it is not necessary to evaluate whether the claimant can perform their part-time, mandatory overtime, or work on an alternative work schedule job as actually performed.If the claimant’s RFC reflects an inability to sustain a 40-hour workweek and the claimant has part-time PRW, both the RFC and the PRW description need to be detailed enough to do a function-by-function evaluation of the claimant’s ability to do their past relevant part-time work.

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HALLOWEEN Escape room

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The claimant reported being able to elevate her legs while working. It is unclear whether the claimant can elevate her legs during normal work breaks.

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The MC responds and makes clear that he does not see support for an inability to sustain (INTS). He does see support for sedentary level exertion with limitations in standing and walking.

Clarifying the claimant's past work will help you to assess whether an allowance is possible and give you insights into how to craft a proposed RFC, if needed.

The MC responds that there is not enough to show a listing is met or equaled.

The claimant reported she had to be on the phone for at least 4 hours and 15 minutes per day in order to perform her job.

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Go back

The claimant talked on the telephone all day

The ability to sit and stand at will will not result in an allowance as the claimant reported flexibility in her ability to alternate positions.

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Unless the breaks are in addition to regular breaks it would not preclude the claimant's past work as generally or actually performed.

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The claimant had to sit down in order to use the phone. She did not have a stand up desk. She was plugged in to the computer wearing a headset.

We must "ensure that information about the claimant’s PRW is detailed enough to compare the requirements of the work with the claimant’s [RFC] on a function-by-function basis." "If the evidence does not permit a function-by-function comparison, [we must] obtain additional information from the claimant or a third party." "If the evidence the claimant or the third party provided about how the claimant performed the PRW appears internally inconsistent, clarify the inconsistency before determining whether the claimant can do PRW as they performed it."

DI 25005.020 Past Relevant Work (PRW) as the Claimant Performed It

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