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WHAT IS A RESIDUAL FUNCTIONAL CAPACITY? HOW DOES IT HELP MY DISABILITY CLAIM?

What is a Residual Functional Capacity (RFC)? It's a term most of don't use; however, it can help you get Social Security disability (SSDI) benefits. In fact, an RFC report from your doctor by be the most important piece of medical evidence that you provide to Social Security. Why?

Because Social Security decides eligibility for disability payments based on one question: ARE YOU ABLE TO WORK?

Whether you are able to work or not depends on how much work activity you can perform in an 8-hour workday: how much sitting, standing, lifting, bending, reaching, squatting, kneeling, crouching, crawling, etc. The estimates must be very specific. For example: "This individual would be limited to sitting no more than 1 hour at a time or 4 hours during an 8-hour day." Or, "This individual could lift no more than 10 pounds occasionally." Or, "This patient will be restricted to only occasional reaching with the right dominant extremity."

What is there are cognitive or mental limitations? These will also be considered by Social Security. Again, just like physical limitations, mental restrictions must be specific. Here are some examples of specific mental restrictions. "This individual will be to understand, remember and carry out only simple 1 or 2 step instructions and tasks on an occasional basis." Or, "This patient will be off task at least 20 percent of an 8-hour workday." Or, this individual's ability to respond appropriately to co-workers, supervisors and the general public has MARKED limitations."

Where does a Residual Functional Capacity come from.

(1) The best place to get an RFC is from one of your long-time treating doctors. These doctors have the records to support their RFC opinion and give it more authority or "weight."

(2) If you don't have an RFC from an acceptable medical source, Social Security decision makers must make up their own RFC assessment, which is often not helpful to you. In fact, in Step 3 of the sequential decision-making process, Social Security must adopt a residual functional capacity which they believe suits you. All of Social Security's hypothetical questions to the administrative law judge will be based on the RFC that is adopted, and may direct toward a finding of "disabled" or "not disabled" under their regulations.

What will Social Security consider when your doctor gives them an RFC opinion?


First, is the doctor well qualified to provide such an opinion? Is he/she an "acceptable medical source" to Social Security. Generally any licensed MD or DO is acceptable. Some other sources may be, also,. such as a optometrist's opinion for eye problems, or a podiatrist's opinion for disorders of the feet or ankles. A licensed psychologists is qualified to provide mental evaluations.

Second, has the doctor had ample opportunity to examine you, perform tests or treatment over a sufficient period of time to know about your ability to function? A doctor who has only seen you once or twice may be judged unqualified to offer functional opinions. The longer the doctor has treated you, the more credible he or she will be to Social Security.

Third, are the limitations proposed in the Residual Functional Capacity consistent with the complete medical record? If a doctor's RFC is inconsistent with what several other treating sources have found in your record, Social Security may fail to give it credibility.

Fourth, are there objective medical reasons to explain the restrictions in the RFC? For example, if a claimant claims chronic and severe back pain which limits the ability to sit, stand or walk-- is there an acceptable medical reason to explain it? Does the claimant have a herniated disc, spinal stenosis or severe degenerative disc --and is this proven by X-rays, MRIs or other objective medical analysis?

If you are about to apply for disability benefits or if you are going before an administrative law judge for an appeal hearing, try to get an RFC statement from your doctor. If you are represented by a qualified advocate or attorney, he/she will help you obtain an acceptable RFC from your doctor(s).

Statements by Doctors Which Are of No Value

General statements by doctors have no weight with Social Security and are worthless. Here are a couple of examples of useless statements from doctors:

"I have treated Mr. John Jones for 10 years. I find him to be disabled due to back pain, chronic headache and anxiety. He should be awarded disability benefits."

"I am Dr. Feelbetter and I have treated Mr. Jones for 15 years. He is not able to work at any job."

According to federal regulations, doctors may not draw conclusions about who can work and who cannot. They may not decide who is disabled under Social Security rules. Under Code of Federal Regulations § 404.1520b, these decisions are reserved to the Commissioner of Social Security. Only the Commissioner may determine who is disabled and who is not, or who can work and who cannot.
 
Your doctor may place limits on Function (sitting, walking, lifting, bending, etc.) - not on the ability to work generally.
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Need Help? Social security disability is technical, difficult and complex. Call the experts at The Forsythe Firm (256) 799-0297. Free consultation. Never a fee unless you recover back payments. 



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