SSR 83-10 / 96-9p Grounded MetLife Any Occ Defense L5-S1 & CLL Clinical Profile

Sedentary Code Capacity & LTD Vocational Evidence Mapper

Case Background: 48-year-old former drywaller (15 yrs) & towboat chemical tankerman with an Associate Degree in Computer Programming. Denied SSDI & facing MetLife 12-to-24 month “Any Occupation” benefit cutoff. Insurer presumes programming credentials allow full sedentary employment, ignoring L5-S1 disc herniation and CLL fatigue that restrict daily sitting to 60 minutes and mandate supine bed rest.

Residual Functional Capacity (RFC) Inputs

Interactive Live Scrub
1.0 hr/day (60 min)
DOT Sedentary standard requires at least 6.0 hours sustained sitting.
20 minutes
L5-S1 radiculopathy triggers acute spasm past 20 minutes.
20.0 hrs/day
Hours spent reclined offloading spine pressure and CLL fatigue.
45 minutes
Degraded by opioid dosing (3x/day) and gabapentin brain fog.
1.5 hrs/day
Total allowable typing duration without severe cervical/lumbar referral.

Capacity vs DOT Sedentary Demands

Deficit: 5.0 hrs Sitting
Autosaved to LocalStorage

DOT Occupational Benchmark & Insurer Discrepancy Breakdown

Complete Physical Preclusion

Junior Web Developer (DOT 030.062-010)

  • Sitting Demand: DOT requires 6.0 hrs/day. Claimant capacity is 1.0 hr/day (Shortfall: 5.0 hrs).
  • Pacing Demand: Stand-up meetings and 8-hour sprints conflict with mandatory 20-min posture changes.
  • Cognitive Demand: Complex logic syntax requires uninterrupted 2-4 hr focus blocks; claimant drops after 45 mins.
Attendance Cliff Rejection

Software QA Analyst (O*NET 15-1253.00)

  • Attendance Requirement: Standard competitive employment tolerates < 1 unscheduled absence/month.
  • Claimant Medical Schedule: CLL monitoring, hypertension spikes (153/103), and acute flare-ups average 4-6 lost days/month.
  • Keyboarding Demand: Repetitive ticket logging exceeds 1.5 hr/day physical upper extremity capacity.
Sub-SGA Asynchronous Potential Only

Technical Doc Writer (DOT 131.267-026)

  • Micro-Task Adaptation: Feasible only with supine bed-mount display and voice-coding (Talon dictation).
  • Sustainable Capacity: Max 6.5 hours/week of fragmented asynchronous output.
  • Vocational Impact: Generates ~$975/mo, well under full-time gainful employment, proving continued LTD total disability.

MetLife 12-to-24 Month LTD Defense & SSDI SGA Pacing Simulator

Safe Sub-SGA ($975 / $1,550 limit)

Claimant Financial & Policy Matrix

MetLife Monthly Gross LTD Benefit: $3,400.00
Insurer Defense Theory: Sedentary Coding Employability
SSDI 2026 Non-Blind SGA Ceiling: $1,550.00 / mo
Trial Work Period (TWP) Trigger: $1,110.00 / mo
Projected Sustainable Async Work (6.5 hrs/wk @ $35/hr): $975.00 / mo
Pacing Defense: By restricting asynchronous remote coding to 6.5 hours weekly, monthly gross earnings remain at $975.00, which is safely below both the Trial Work Period ($1,110) and SGA ceiling ($1,550). This protects pending SSDI appeals while refuting insurer assertions of full-time work capability.

Generated Medical-Vocational Appeal Brief Excerpt

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