Occupations that require Manual Dexterity Musical Instrument Repairers and Tuners Repair percussion, stringed, reed, or wind instruments. May specialize in one area, such as piano tuning. Manual dexterity involves the development of hand-eye coordination and very fine motor control. Imagine the level of care and precision required in certain activities, hobbies and professions that.

Social Security Ruling 96-9p examines the effect of various functional limitations on a Social Security disability claimant’s ability to perform the full range of sedentary work. Although SSR 85-15 generally discusses the effect of manipulative limitations on a claimant’s ability to work, SSR 96-9p is the first ruling to provide that any significant manipulative limitation necessarily results in the “significant erosion of the unskilled sedentary occupational base.” Based on this ruling, the ALJ has the authority to find a claimant disabled under such circumstances. Additionally, the ALJ arguably must obtain vocational expert testimony to establish that a claimant (who is otherwise limited to sedentary work and suffers from significant manipulative limitations) can perform other work.

Tip

If you suffer from medically documented manipulative limitations and are limited to unskilled sedentary work, your attorney should argue that the unskilled sedentary work base has been significantly eroded and that a finding of disabled is required. Alternatively, your attorney should argue that in light of your manipulative limitations, vocational expert testimony is needed to establish the existence of other work that you can perform.

Regulations

20 C.F.R. §§ 404.1545, 416.945

The regulations provide that a limited ability to perform certain physical demands of work activity, including manipulative functions such as reaching and handling, may reduce a claimant’s ability to do past work and other work.

20 C.F.R. §§ 404.1569a, 416.969a

Some examples of nonexertional limitations or restrictions include difficulty performing the manipulative or postural functions of some work such as reaching, handling, stooping, climbing, crawling, or crouching.

Rulings

Social Security Ruling 96-9p

SSR 96-9p provides that most unskilled sedentary jobs require good use of both hands and the fingers; i.e., bilateral manual dexterity. Fine movements of small objects require use of the fingers, e.g., to pick or pinch. Id. “Most unskilled sedentary jobs require good use of the hands and fingers for repetitive hand-finger actions.” Id.

Examples Of Activities Requiring Manual Dexterity

SSR 96-9p further provides that:

Any significant manipulative limitation of an individual’s ability to handle and work with small objects with both hands will result in a significant erosion of the unskilled sedentary occupational base.

Social Security Ruling 85-15

Examples Of Activities Requiring Manual Dexterity Will

SSR 85-15 provides that reaching, handling, fingering, and feeling require progressively finer usage of the upper extremities to perform work-related activities. Reaching (extending the hands and arms in any direction) and handling (seizing, holding, grasping, turning or otherwise working primarily with the whole hand or hands) are activities required in almost all jobs. Significant limitations of reaching or handling may eliminate a large number of occupations a person could otherwise do. Varying degrees of limitations would have different effects, and a VE’s assistance might be needed to determine the effects of the limitations.

Fingering involves picking, pinching, or otherwise working primarily with the fingers. It is needed to perform most unskilled sedentary jobs and to perform certain skilled and semiskilled jobs at all levels of exertion. As a general rule, limitations of fine manual dexterity have greater adjudicative significance — in terms of relative numbers of jobs in which the function is required — as the person’s exertional RFC decreases. Thus, the loss of fine manual dexterity narrows the sedentary and light ranges of work much more than it does the medium, heavy, and very heavy ranges of work. The varying degrees of loss which can occur may require the adjudicator to have a VE’s assistance. However, a VE would not ordinarily be required where a person has lost the ability to feel the size, shape, temperature, or texture of an object by the fingertips, since this is a function required in very few jobs.

Social Security Ruling 83-14

SSR 83-14 describes Example 1 of § 201.00(h) of the Grids as illustrating that a limitation to unskilled sedentary work, with an additional loss of bilateral manual dexterity that is significant, warrants a conclusion of “disabled.” SSR 83-14 further notes that the bulk of unskilled sedentary jobs requires bilateral manual dexterity.

Case Law

First Circuit

In Heggarty v. Sullivan, 947 F.2d 990 (1^st Cir. 1991), the court found that where uncontradicted medical evidence indicated that the claimant’s manual dexterity was limited, the ALJ’s conclusion that the claimant retained the capacity to perform the full range of sedentary work was not supported by substantial evidence and a remand for vocational evidence was required. Id. at 996-97.

In Prentice, the Commissioner moved for a remand pursuant to sentence four of 42 U.S.C. § 405(g), conceding that the claimant suffered from a nonexertional impairment (a manual-dexterity problem) which was significant enough to have undermined the administrative law judge’s sole reliance on the Medical-Vocational Guidelines, and contending that the appropriate remedy was remand for rehearing to obtain vocational expert testimony. Prentice v. Barnhart, 256 F. Supp.2d 4, 5-6 (D. Me. 2003). The claimant opposed the remand, and instead argued that his entitlement to benefits was clear enough to warrant remand with instructions to pay benefits. Id. at 6. In support, the claimant cited Social Security Ruling 96-9p for the proposition that a person “who is limited to unskilled sedentary work and lacks any manual dexterity of his non-dominant hand is ipso facto disabled.” Id. The court disagreed, citing three reasons: (1) nowhere in SSR 96-9p does it clearly direct that a claimant be found “disabled”; (2) circuit courts have rejected arguments similar to that made by the claimant’s and (3) the Commissioner clarified, in deleting example 1 of section 201.00(h) from the Grids effective September 27, 2001, that the agency has always intended that the example not be construed to direct a finding of disability. Id. at 7. As SSR 96-9p does not clearly direct a finding of disabled, remand with instructions for rehearing as requested by the Commissioner, rather than remand with instructions to pay benefits, was the appropriate remedy. Id. at 8.

Fifth Circuit

The Fifth Circuit rejected the claimant’s argument that the ALJ failed to obtain vocational expert testimony despite his limitation to sedentary work and his manipulative limitations. Hernandez v. Heckler, 704 F.2d 857, 861 (5^th Cir. 1983).

Sixth Circuit

“As a general rule, limitations of fine manual dexterity have more significance regarding sedentary ranges of work than in medium ranges of work, because sedentary jobs commonly require such function.” Henderson v. Apfel, 142 F. Supp.2d 943, 946-47 (W.D. Tenn. 2001), citing SSR 85-15 and SSR 96-9p.

Noting that § 201.00 of the Grids did not mandate a finding of disability, the court stated that although the claimant was limited in his ability to engage in fine manipulation, he did not lack bilateral manual dexterity, both gross and fine, as did the claimant in § 201.00. Therefore, the Grids did not direct a finding of disability under the circumstances presented. Preston v. Sullivan, 785 F. Supp. 1267, 1272 (S.D. Ohio 1992).

Seventh Circuit

While most unskilled sedentary jobs require good use of the hands and fingers for repetitive hand-finger actions, there was sufficient evidence to support a finding that the claimant could perform sedentary jobs. Diaz v. Chater, 55 F.3d 300, 309 (7^th Cir. 1995).

Although the claimant could not perform such manipulations as changing a spark plug, but admitted that he had the ability to perform fine manipulations such as picking up a rubber band, the ALJ properly concluded that the claimant’s capability to perform the full range of sedentary work was not significantly impacted by his hand res