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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!

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