YOU CAN'T WIN WITHOUT A PROPER "RESIDUAL FUNCTIONAL CAPACITY"

You're trying to get benefits from Social Security because you are disabled. They may not believe you. In fact, they will deny 70 percent of all claims. There's one thing that can help you win on appeal.

What is a "Residual Functional Capacity" or RFC?

RFC simply means the amount of work you are still able to do in spite of all your impairments.

Where does the RFC come from?

In a worse case scenario, Social Security makes up their own Residual Functional Capacity (RFC). This often results in denial.

In a better scenario, the claimant's own doctor provides an RFC opinion. This can really help win the case.

Here are some facts you need to know about the RFC opinion from your doctor:

It must come from your doctor who knows you and has treated you for awhile.
It must be specific and on the correct form.
Letters from doctors don't work; get the right form for your doctor to complete.
Understand that your doctor may only provide an "opinion." The doctor cannot approve or "sign you up" for disability benefits.
In most cases, the RFC opinion must be signed by a MEDICAL DOCTOR, not a nurse practitioner, counselor, therapist, chiropractor or social worker.
The opinions expressed must be those of the doctor, not the patient's opinions written on an RFC form.
Medical records from your doctor will not contain a residual functional capacity (RFC). You must ask for this special.
The doctor completing the RFC should not refer you out to another doctor or specialist to complete the form. The value of the opinion comes from the fact that it is an opinion of your treating physician who knows you well and has had months or years to observe your medical history, conditions and how they impact you. A new doctor cannot know this and cannot give you a useful RFC opinion.

A USELESS "RFC" THAT DOES YOU NO GOOD:

Doctor says, "I have treated Mr. Patient for 12 years and he suffers from degenerative arthritis, migraine headaches and heart problems. It is my opinion that Mr. Patient is totally disabled and unable to work at any job." (Doctors are not permitted to draw this conclusion under law).

EXAMPLE OF A MORE USEFUL RFC

"Mr. Patient will be restricted in the following activities:

He can sit for up to 30 minutes at a time or up to 4 hrs. per 8-hr. day.

He can stand for 15 minutes at a time and p to 2 hours per 8-hr. day.

Is restricted to lifting/carrying no more than 10 pounds occasionally.

Will require a 10-15 minute break every hour due to back and leg pain.

Is expected to be off task at least 20 percent of a work day.

May use his dominant right hand occasionally for overhead reaching.

These are the types of SPECIFIC restrictions that can help Social Security decide whether there is any work that you can still perform.

Finally, the RFC opinion must come from a doctor who has actually treated you and examined you over a relatively substantial period of time. It is up to the claimant or their attorney to get the RFC form from the doctor and submit it to Social Security. Social Security almost never obtains the RFC opinion on their own, and certainly not from your own doctor. (An RFC from one of Social Security's doctors almost never helps your case).

WHAT YOU WILL BE ASKED AT A DISABILITY HEARING

Most Social Security disability claims will be denied twice: First at the end of the Application process, and again after the "Reconsideration" process. The third stop will be a hearing before a federal Administrative Law Judge (ALJ). It is here at the hearing level that most SSDI claims are paid. So, what do you need to know about your Social Security disability hearing? First, the judge will follow the rules established by the Social Security Administration. His or her job is to determine whether you meet the particular laws and rules to receive disability payments. So, it is a legal proceeding where you must prove certain things in order to get paid. Among the things you must prove: Your insured status with Social Security: You have worked recently enough and paid into the Social Security trust fund to gain the required "work credits" to support your claim. You have a severe medical or mental impairment supported by adequa...

MISTAKES THAT RUIN A SOCIAL SECURITY DISABILITY APPLICATION

MISTAKES THAT RUIN A SOCIAL SECURITY DISABILITY APPLICATION The paperwork for Social Security disability is daunting: page after page of never-ending questions. But, since most applications will be denied, it behooves you to complete the application correctly. Here are some mistakes on your Social Security disability application that may ruin your claim. Failing to Fill Out the Forms —The Social Security Administration (SSA) will send you a lot of forms to fill out. It’s up to you to make sure that you fill out every part of those forms correctly. Don’t forget: if a question doesn’t apply to you, put “not applicable” or “N/A” in the provided space. Do not leave anything blank. Return all forms within 10 days. If you don't your application may be discarded or withdrawn. Writing Illegibly —If your case reviewer can’t read your answers, then he/she can’t really say that you answered that question. Be sure the answers to questions are nea...

WHAT TYPE OF DENIALS DOES SOCIAL SECURITY ISSUE?

In Social Security disability, the most common denials are medical denials. This means that Social Security doesn't believe the medical evidence in your case meets the exacting standards for an award of disability. There are technically two kinds of medical denials: 1. You are able to perform some of your past relevant work. They have looked at your work history for the past 15 years and judged that your medical conditions permit you to perform one or more of your past jobs. This is what we call a "Step 4 denial." 2. You are not able to perform any of your past work - but there is other work in the national economy that you are able to do. This is called a "Step 5 denial" because it occurs at the 5th and final "step" in the decision making process. There are other types of denials, not nearly as common as the two above. We sometimes think of these as "automatic" denials or "technical denials." They are not medical decisions...

DISABILITY SURVIVAL GUIDE: NORTH ALABAMA EDITION

Search This Blog