Functional limitations from your disability can affect your ability to do your job and may support a disability claim. Your condition may cause limitations or restrictions that affect your job and prevent you from performing the requirements of your occupation or other occupations. You may suffer from exertional limitations, non-exertional limitations, or a combination thereof.
Your exertional and non-exertional limitations are very important. The insurance company considers them to identify work activities that you can still perform. The work activities that you can perform, despite your condition, are collectively known as your “residual functional capacity.”
The insurance company will compare your residual functional capacity to the requirements of your own occupation and/or other occupations to determine whether you are disabled. If your residual functional capacity is less than that required for your own occupation and/or any other occupations, then you are disabled.
What are exertional limitations?
"Exertional” limitations are limitations that affect your ability to meet the strength demands of a job.
Exertional limitations include:
Categorization of these limitations as “exertional” is closely related to the United States Department of Labor’s job classifications by exertional levels (sedentary, light, medium, heavy, and very heavy). The insurance companies frequently refer to the Dictionary of Occupational Titles (a Department of Labor publication) to determine a job’s exertional level and requirements.
The exertional levels are categorized for job classification purposes as follows:
- Sedentary: This work involves little no more than 10 pounds and occasionally lifting or carrying articles like docket files, ledgers, and small tools. This work generally requires sitting a total of 6 hours of an 8 hour workday and occasional standing/walking to perform certain job duties (typically no more than 2 hours a day). This work requires the ability to frequently use hands and fingers for repetitive activities.
- Light: This work involves lifting no more than 20 pounds at a time with frequent lifting/carrying of objects weighing up to 10 pounds. This work also requires standing and/or walking for approximately 6 hours in an 8 hour workday.
- Medium: This work involves lifting no more than 50 pounds at a time with frequent lifting/carrying of objects weighing up to 25 pounds. This work also requires standing and/or walking for approximately 6 hours in an 8 hour workday.
- Heavy: This work involves lifting no more than 100 pounds at a time with frequent lifting/carrying of objects weighing up to 50 pounds. This work also requires standing and/or walking for approximately 6 hours in an 8 hour workday.
If you cannot meet the exertional demands of an occupation, then you are considered disabled for that occupation.
What are non-exertional limitations?
“Non-exertional” limitations are limitations that do not impact your ability to perform the exertional demands of an occupation. A limitation may still be considered non-exertional if your condition is physical in nature (i.e., arthritis in your hands makes it difficult for you to type).
The main types of non-exertional limitations include:
- Manipulative: Manipulative limitations are those that impact your ability to use your hands and/or fingers. If you have difficulty typing, writing, grasping small objects, or keeping your hands from shaking, then you likely have manipulative limitations.
- Mental: Mental limitations are those that impact your mental functioning. The limitation may be due to a mental disorder, cognitive disorder, distracting pain, and/or medication side-effects. If you have difficulty concentrating, focusing, remembering things, or processing information, then you may have a mental limitations.
- Postural: Postural limitations are those that impact your ability to kneel, bend, twist, squat, turn your head, and/or stoop. Postural limitations can also involve special positioning limitations, such as needing to elevate your foot, while in a static position.
- Environmental: Environmental limitations involve your ability to tolerate exposure to common environmental factors, such as dust, noise, fumes, temperature extremes, pulmonary irritants, or normal work hazards.
- Sensory: Sensory limitations involve your ability to see, hear, and/or feel. These limitations often impact your ability to communicate. They may also impact your ability to be around certain work hazards.
If you cannot perform the non-exertional demands of an occupation, then you are considered disabled for that occupation.
What if I have a combination of exertional and non-exertional limitations?
If you have a combination of exertional and non-exertional limitations, the insurance company will consider the combined impact that those limitations have on your ability to work.
Demonstrating your limitations to the insurance company
The success of your claim may very well depend on whether the insurance company knows about all of your limitations. This is particularly true when your policy requires that you are unable to perform any occupations, rather than just your own.
Riemer Hess understands the vocational impact and importance of your exertional and non-exertional limitations. Our experienced legal team will make sure that your particular exertional and non-exertional limitations are presented to the insurance company in a clear and comprehensive manner to maximize your chances of approval. Contact an attorney at Riemer Hess today to discuss how we can highlight your limitations to maximize your chances of approval.