What are Functional Limitations?
A functional limitation is a limiting factor caused by a disabling condition that affects your ability to perform at work. A condition, whether an injury or illness, can prevent you from fulfilling the requirements of your job. Because of this, it can be important to identify your functional limitations if you are considering filing a long-term disability claim.
Identifying your limits can be vital to your claim. The insurance company will consider them when looking into which work tasks you may still be able to perform. The insurance company will generally refer to tasks you can still perform at work as “residual functional capacity.” Usually, they will compare your residual functional capacity to your job requirements. This will help them determine if you could be considered disabled. If your residual functional capacity is less than the occupation requires, then you may qualify as having a disability.
Generally, there are 2 types of functional limitations. These are exertional and non-exertional limitations. Your condition may cause one or both of these types. Below, we will discuss each of these types.
What are Exertional Limitations?
Exertional limitations are limiting factors that affect your ability to perform physical job tasks. These include physical tasks that require some level of strength to perform. The types of tasks that are usually included in this category include:
Generally, the reason these tasks are categorized as exertional is because of the department of labor. Your long-term disability insurance company will usually use the Dictionary of Occupational Titles from the department of labor. Depending on your occupation, the exertional levels are categorized by the level of exertion needed.
Exertional Levels For Job Classification
The classification of exertion levels is broken down by the Department of Labor into 5 categories. The 5 strength levels are Sedentary, Light, Medium, Heavy, and Very Heavy. Below, we will provide an explanation of each level. If you cannot meet the exertional demands of your occupation, you could be considered disabled.
Sedentary work involves little physical labor. Generally, this work will involve lifting no more than 10 pounds. Examples may include tasks such as carrying ledgers, files, or small tools. Sedentary jobs are also classified as sitting for 6 or more hours of the workday, and occasionally standing or walking for certain tasks. This classification will often require frequent use of the hands and fingers for typing, writing, or other similar activities.
Light work involves lifting up to 20, with frequent occurrences of lifting objects of up to 10 pounds. With light work, you will likely be standing or walking for about 6 hours of an 8-hour workday.
Medium work usually requires the lifting of no more than 50 pounds at a time and frequently lifting objects of about 25 lbs. You may also be required to use up to 10 lbs of force for the majority of the day. This type of job generally involves standing for at least 6 hours of an 8-hour workday.
Heavy work generally involves the lifting of no more than 100 pounds at a time, with frequent lifting of roughly 50 lbs at a time. This may also involve using about 10-20 lbs of force at a near-constant rate throughout the day. With this type of job, you will likely be standing for more than 6 hours of an 8-hour shift.
Very Heavy work involves a very small percentage of the workforce, according to the Bureau of Labor Statistics. It involves carrying over 100 lbs at a time, with frequent lifting in excess of 50 lbs. You will likely be required to use over 20 lbs of force constantly. Overall, a worker in this category will likely be moving or standing for the majority of an 8-hour shift.
What are Non-Exertional Limitations?
Non-exertional limitations are functional limitations that do not require physical demands. A task may still be physical while being non-exertional. Generally, “non-exertional” just refers to tasks that do not involve strength. If you can’t perform the non-exertional limitations of a job, then you may be considered disabled.
There are a few main types of non-exertional limitations. These are environmental, manipulative, mental, postural, and sensory.
Environmental limitations are those posed by the workplace environment. Your debilitating health condition may prevent you from safely operating in or navigating the workplace environment. These may include extreme temperatures, dust, noise, fumes, irritants, or other workplace hazards.
Manipulative limitations refer to tasks that utilize your hands and fingers. Tasks in this category may include typing, writing, grasping small objects, or keeping your hands from shaking. These generally require some fine motor skills.
Mental limitations are those that impact your cognitive or mental functioning. These may be caused by a cognitive deficit, mental disorder, medication side effects, or distractions from the pain. Examples of mental limitations may include difficulty concentrating, poor focus, memory issues, or information processing issues.
Postural limitations are those that affect your ability to bend, kneel, squat, twist, turn, etc. These limitations may involve special positioning, like needing to elevate your foot while sitting, for example. Postural limitations are common after a debilitating injury or with a condition that affects your mobility.
Sensory limitations are those that involve your sight, hearing, or sense of touch. They may limit your ability to communicate. Limitations to the senses can also increase the risk of further injury in the workplace. Overall, they can impact your capacity to work in certain environments.
Having Both Exertional and Non-Exertional Functional Limitations
It is not uncommon to experience both exertional and non-exertional limitations. Many health conditions that affect your physical capabilities can also impact other aspects. Generally, the insurance company should consider the combined impact of all of your functional limitations. It is important to include any and all of your functional limitations in your long-term disability insurance claim.
Proving Your Functional Limitations to your Insurance Company
The success of your long-term disability claim may hinge on making sure the insurance company has all of the facts. As mentioned above, it is important that all of your functional limitations are mentioned in your claim. This can be especially important if your particular policy requires that you cannot perform tasks at any occupation, instead of just your own. Proving your functional limitations will require evidence to support your claim. Statements from your doctor or supervisor may be critical in providing support.
Additionally, you may want to consider taking a Functional Capacity Evaluation (FCE), or a Neuropsychological Evaluation to support your claim. Both are special evaluations that test your limitations. An FCE tests your physical limitations and the impact of fatigue. This can be a good way to show your exertional limitations. A neuropsychological evaluation quantifies cognitive and mental deficits, such as those that would be considered a mental, non-exertional limitation. Your disability attorney can help you determine if either of these tests can be beneficial to your claim.