Relating ORS Occupational Demands to Residual Functional Capacity
Rick Wickstrom, PT, DPT, CPE was invited to Washington, D.C. by the National Academy of Sciences to present and discuss residual functional capacity with its Standing Committee of Medical Experts and SSA staff in the Office of Disability Policy. Other invited guest experts included Melanie T. Ellexson, HDHc, MBA, OTR/L, FAOTA (occupational therapist), Amy E Vercillo ScD, CRC, CDMS, LRC (vocational expert), and Elizabeth Twamley, PhD (Research Psychologist). This meeting was requested by the Social Security Administration (SSA) to ensure that Occupational Requirements Survey (ORS) elements are consistent with the current SSA data collection process for disability benefit applications.
The ORS survey was initiated in 2012 by the Bureau of Labor Statistics (BLS). The ORS gathers job-related information regarding physical demands, environmental conditions, mental and cognitive demands, and vocational preparation requirements. SSA funded the ORS to aid in determining eligibility for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) disability benefits for applicants. The ORS has been testing the usefulness of many new data elements to improve the collection of occupational information. BLS found after the first two years of collection that the mental-cognitive questions needed to be further simplified. A new set of ORS questions and responses will be collected in the 5-year refresh cycle for the ORS that just started.
For disability adjudication, SSA staff reports a primary concern of identifying the least mentally and physically demanding work that can be performed by people that have disabilities in the economy. The ORS survey was initiated by SSA in response to validity concerns by multiple stakeholders that occupational information in the Dictionary of Occupational Titles (DOT) has not been updated since 1991. This meeting included interactive discussions about best practices for gathering and relating case evidence of residual functional capacity to ORS elements.
SSA is continuing its efforts to develop new Mental and Physical RFC forms that align with the ORS. Staff members expressed an interest in identifying affordable tests that would reduce the amount of subjective bias and inconsistency of case evidence. Guest experts made several suggestions for how the ORS worker-job taxonomy elements and application process could be improved to reduce the backlog of pending claims and redirect applicants to engage in programs that promote return to suitable employment. Dr. Wickstrom shared his experience with creating a reference tool on the WorkerFIT platform to search for job modifications based on limited physical and cognitive factors.