We take the use of our hands for granted – nearly every task requires full use of the hands. Anyone who has “manipulative limitations” caused by injury or pain should know that this can be an important component of a disability claim. This limitation can be particularly important when it is not THE major disabling condition.
Social Security law says that in order to perform any work, even unskilled and sedentary work, a person must have good use of both hands and the fingers. This is called “bilateral manual dexterity” in the regulations. Any significant limitation in a person’s ability to handle, pick up and finger small objects is important in the disability decision. If someone cannot write or type because of pain, their job opportunities are quite curtailed.
Many claimants have conditions that restrict the amount of lifting they can do. A person who can lift and carry even 10 pounds for most of the day may still be found capable of sedentary work, under Social Security regulations. The addition of the factor of a manipulative limitation, particularly of the dominant hand, can be enough to tip the scale in favor of the claimant. Often when Social Security is collecting from a claimant, the focus is on lifting, standing and sitting limits. It is essential to do careful medical record development around limits on use of the hands. These limitations may sometimes be viewed as a minor problem in the context of some larger disease process. It’s essential to get this recorded in the medical record.
When the right questions are asked of the medical provider, however, a clearer picture may emerge. Does the person have pain in the dominant hand? Is the pain increased by repetitive use? Someone may be able to lift five pounds, or use the painful hand for a task once or even five times, but can this be done on a continuous, repetitive basis for an eight hour work day, five days a week? What is the effect of such an activity level on the person’s overall condition?