Social Security Disability, SSI, and Residual Functional Capacity, RFC

Residual functional capacity is simply defined as the remaining functional capacity a person has in spite of possessing a physical or mental impairment.

Residual functional capacity is a cornerstone of the SSI and Social Security Disability evaluation process because the rating, or assessment, that is given to a claimant will determine whether nor not they will qualify for disability and be awarded SSD or SSI benefits.

How is residual functional capacity measured? A disability examiner (or a judge if the case has gone to the hearing level) will use the information contained in the available medical records to get an idea of how a person is physically or mentally limited.

"Available medical records" will include all the medical evidence that has been received from the claimant's doctors, clinics, and hospitals. It can also include any supporting statements received from the claimant's doctors, particularly the claimant's treating physician (a treating physician is a doctor who has a history of treating a particular condition for a person and is, therefore, most suitably qualified to speak as to how it affects the individual).

Medical records, for the most part, do not contain references to specific problems that a person might have as a result of their condition. For example, difficulty using a pen or eating utensils if the person has carpal tunnel syndrome, or difficulty doing desk work if they have chronic back or hip pain. Or difficulty with short-term memory if they have a mental disorder or a head injury.

In most cases, doctors are more focused on just putting basic treatment information in their notes and do not ordinarily record information about functional limitations.

For this reason, disability examiners who are trying to extrapolate what a claimant's current RFC, or residual functional capacity, might be will also conduct telephone interviews with both a claimant and someone who knows about their condition (this person is known as a third-party contact). The purpose of this type of interview is to gain insight into the claimant's activities of daily living (e.g. does the person have trouble vacuuming, making shopping lists, trouble lifting a laundry basket). The reasoning behind this is that having trouble with normal daily activities may also mean having trouble with many different types of job duties.

Using information obtained from both the medical evidence as well as from ADL (activities of daily living) questionaires, a disability examiner will attempt to discern how functionally limited a claimant is. And this assessment will be recorded on an RFC form. How valid is the RFC form?

In most instances, a disability examiner will be required to have their assessment reviewed by a medical doctor or a psychologist who works in their case processing unit to ensure that they have made an accurate assessment.

How does the RFC assessment affect the outcome of a disability case? The assessment of the individual's remaining capabilities is compared to whatever type of work they did in the past. If they are currently too limited to return to one of their former jobs performed within the past 15 years, they may possibly qualify for disability.

However, this is further contingent upon them not having sufficient education, training, and remaining physical and mental capabilities to learn some type of other work.

Note: very often, claimants are given both a physical and a mental rating since a high percentage of claimants file on the basis of multiple physical and mental conditions.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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