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

MOST IMPORTANT FACTORS IN A SOCIAL SECURITY DISABILITY CASE

What are the top 3 most important factors in a Social Security disability case? 1.  Medical Evidence. 2.  Medical Evidence 3.  Medical Evidence 4-10     Medical Evidence Federal regulations set the eligibility requirements for Social Security disability (SSDI) benefits.  A claimant must meet these strict legal requirements More than anything else, the claimant's medical evidence will determine the outcome of the claim or appeal.  Without strong objective medical evidence Social Security cannot legally pay you a benefit. Objective Medical Evidence means the result of medical examinations, laboratory tests or imaging studies (X-rays, PT scans, MRI or CT scans). This type of evidence can only be obtained by going to your doctor. There's an old adage that says truthfully:  "The path to Social Security disability benefits runs straight through your doctor's office."  Being approved for an SSDI benefit requires objective medical proof. ...
Post a Comment
Read more

IS IT HARD TO GET SOCIAL SECURITY DISABILITY IN TENNESSEE?

  How hard is it to get Social Security disability (SSDI) in Tennessee? It can be very difficult.  In the beginning stages of the process, it seems like the agency is out to deny as many claims as possible.  Later--in the appeals process--it takes more technical and legal skill to move through the labyrinth of obstacles. What's the usual reason for an SSDI denial? If you look at all the denial letters, the most comm on reason given is:  You are not disabled according to our rules. The 2 main explanation for finding claimants not disabled are: 1.  You are able to perform some of your past relevant work. 2.  You can't perform any of your past work but you are able to do other work. Those are the two "catch all" reasons Social Security gives for nearly all of their denials.  Both of these reasons fall into the category of a medical denial .  The claimant's condition is not deemed severe enough to prevent all work. There are other reasons for d...
Post a Comment
Read more

CAN YOU WIN YOUR DISABILITY APPEAL WITHOUT A LAWYER?

The Social Security Administration does not require you to have a lawyer to file an appeal or to appear at a hearing.  However, most people heading for a disability hearing will hire a lawyer or advocate to help them.   Studies have shown that you are about twice as likely to win with a lawyer.  A recent study found that claimants with no lawyer win about 30 percent of the time while claimants with a lawyer or advocate win 60 percent of the time.   " He just cooked his own goose." These statistics cover only one aspect of a disability appear--your odds of winning. The other important aspects are time and convenience. If you prepare and adjudicate your own disability appeal, expect to spend 12 to 24 months working on the case.  You will be collecting, reading and submitting hundreds or thousands of pages of medical records.  These records are complex and often difficult to understand.  And you must know how each medical record helps (or hurts) your dis...
Post a Comment
Read more