Skip to main content

RESIDUAL FUNCTIONAL CAPACITY: YOUR GATEWAY TO DISABILITY APPROVAL

First, what is  "Residual Functional Capacity" or RFC?  The shortest answer:  It is the maximum work that an individual is able to perform."

Social Security will consider a claimant's age, education, past work experience and RFC to determine what type of work, if any, the claimant can still perform.

The more restrictive the RFC is, the more likely benefits can be paid.

For example, if a claimant can still perform medium exertion work activity, it is very likely that there exists over a million jobs that he/she can do.  That would be a quick denial, providing this claimant also has the mental capacity to do full-time work.

However, if a claimant is restricted to sedentary exertion (sitting most of the time and lifting/carrying no more than 10 pounds occasionally, the number of jobs will be reduced and there's a better chance of being awarded benefits.

If a claimant has a Residual Functional Capacity that is below the level of sedentary work, there are no jobs in the national economy for that individual--and an approval is almost certain.

So, the RFC is very important in getting a favorable decision from Social Security.

WHERE DOES THE RFC COME FROM?

The person making a decision about your claim or appeal will come up with an RFC.  This is based, at least vaguely, on the claimant's medical records. Let's look at how medical information may be used to form an RFC.

MEDICAL EVIDENCE FROM YOUR DOCTOR:  This patient has bulging discs at the L2-L3 level and herniated discs at the L4-L5 level.  Patient complains of 8/10 level pain in the low back, made worse with bending, stooping, lifting, or standing/walking.  Patient also complains of numbness in the bilateral lower extremities when standing.  Pitting edema was observed in the left lower extremity on exam.  The patient had trouble getting on/off the exam table without assistance.

AN APPROPRIATE RFC MIGHT BE:

  • This individual can sit for 1 hour at a time and for up to 4 hours per 8-hour day.
  • Can stand and or walk 20 minutes at a time and up to 4 hours per day.
  • Will be limited to lifting and carrying no more than 10 pounds occasionally.
  • May use upper extremities and hands for reaching in all directions, including overhead, frequently.
  • Claimant should not be exposed to unprotected height, use of dangerous machinery or areas of humidity or wetness.
  • Claimant can occasionally stoop, kneel, and crouch-but cannot crawl.

A Social Security decision maker has just transformed the medical evidence into a statement of the claimant's ability to perform work related activities. The RFC states what the claimant CAN and CAN'T do in a workplace setting.

The problem is:  Social Security will often not restrict the claimant's function as much as they should.  As given, the above RFC allows for Sedentary work.  Depending on the claimant's age and past relevant work, that may get a denial.

Consider this:  If we change a couple of things in the RFC above to say:

"The individual can stand and/or walk for a total of 4 hours out of an 8 hour day, and can sit with normal breaks for 2 hours out of an 8-hour day."

This RFC is BELOW the sedentary level and would provide for no work in the national economy and would indicate an approval for benefits.

Obviously, the claimant needs a fair and accurate RFC.  How to get it:

A.  Get all medical records to document all impairments and their severity.

B.  Get one or more treating doctors to provide an RFC.  (Better than letting Social Security  just make up an  RFC)!

C.  Let your lawyer question the vocational expert (at the hearing) about how your work-related restrictions will impact your ability to perform work that exists in the national economy.  Of course, the claimant could question the vocational expert if he/she knew how.  I have to confess:  I have appeared at around 1,500 hearings.  But when I first started as a claimant representative, questioning the vocational expert was the hardest part of the job for me.  It took me months to become proficient in phrasing vocational questions in a proper manner, so the judge wouldn't say:  "Mr. Forsythe, that is not vocational language.  Would you please rephrase your questions for the witness."  

My point, if a claimant is in his or her first hearing, there is no way to know how to handle the vocational testimony.  And your case may sink or swim on the residual functional capacity and the testimony of the vocational witness.  Take your lawyer with you to the hearing.  If (s)he only proves to be useful in handling the vocational witness, it will be worth a mint!

Comments

Post a Comment

Popular posts from this blog

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...
Post a Comment
Read more

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...
Post a Comment
Read more

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...
Post a Comment
Read more