us-ma/regulation/dta/106-cmr/703/703.193 — 703.193 EAEDC Vocational Factors

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(c)has more than a nominal effect on the applicant’s or…#

(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.

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(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 10 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.

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(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.

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(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

(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) 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

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703:193-5

Age | Education | Previous Work Experience | Decision

55 & over | Illiterate or unable to communicate in English | Unskilled or none | Disabled

55 & over | Less than 12 th grade - at least literate | Unskilled or none | Disabled

55 & over | Less than 12 th grade | Skilled or semiskilled - skills not transferable | Disabled

55 & over | Less than 12th grade | Skilled or semiskilled - skills transferable | Not Disabled

55 & over | High school graduate or more - does not provide for direct entry into skilled work | Unskilled or none | Disabled

55 & over | High school graduate or more - provided for direct entry into skilled work | Unskilled or none | Not Disabled

55 & over | High school graduate or more - does not provide for direct entry into skilled work | Skilled or semiskilled - skills not transferable | Disabled

55 & over | High school graduate or more - does not provide for direct entry into skilled work | Skilled or semiskilled - skills not transferable | Not Disabled

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703:193-6

Age | Education | Previous Work Experience | Decision

50 - 54 | Illiterate or unable to communicate in English | Unskilled or none | Disabled

50 - 54 | Less than 12 th grade - at least literate | Unskilled or none | Disabled

50 - 54 | Less than 12 th 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

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703:193-7

Age | Education | Previous Work Experience | Decision

Younger Individual Age 45-49 | Illiterate or unable to communicate in English | Unskilled or none | Disabled

Age 45- 49 | Less than 12 th grade - at least literate | Unskilled or none | Not Disabled

Age 45- 49 | Less than 12 th 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

Younger Individual Age 18 - 44 | Illiterate or unable to communicate in English | Unskilled or none | Not Disabled

Age 18 - 44 | Less than 12 th grade - at least literate | Unskilled or none | Not Disabled

Age 18 - 44 | Less than 12 th 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

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(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.

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.

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(d)Work in the Regional Economy#

(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;

(d) complete tasks in a timely manner; and

703.193 EAEDC Vocational Factors

(a)is documented by medically acceptable clinical and/or…#

(b)is expected to last for at least 30 days; and#

(c)has more than a nominal effect on the applicant’s or…#

(d)Work in the Regional Economy#

(e)adjust to changes in work routine or work environment;…#