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Residual Functional Capacity Forms play a pivotal role in evaluating disability claims. The disability claims handler deciding your long-term disability claim or Social Security Disability claim needs to assess your residual functional capacity (RFC) to determine if you can work. One way to accomplish this is by having a doctor assess your residual functional capacity and complete an RFC form.
Note: This form is also known as an Attending Physician Statement (APS) or a Medical Source Statement (MSS). We will use these terms interchangeably throughout the rest of this article.
What Is a Residual Functional Capacity Assessment?
A residual functional capacity assessment evaluates your impairment(s) and any related symptoms, such as pain, that may cause physical and mental limitations affecting what you can do in a work setting. Your RFC is the most you can still do despite your limitations.
Why RFC Forms Are Better Than Your Records
Many claimants think, “If my medical evidence is strong, why should I get an RFC form completed?”
Your records rarely specify opinions or conclusions regarding your ability to work. The claims examiners at DDS and disability insurance companies are not doctors, so they cannot easily translate medical findings into specific work-related impairments. Submitting completed RFC forms:
- It makes the claims handler’s job easier;
- It allows a claimant to present a professional interpretation of the medical evidence, as opposed to simply submitting the evidence by itself;
- It is far superior to a short statement or letter from a doctor on behalf of a claimant (such letters rarely, if ever, help to win a case) and
- It allows the physician to comment on a claimant’s limitations concerning exertional ability, postural limitations, strength, range of motion, and mobility.
This is why it is essential for a physician to “bridge the gap” between your medical diagnoses and your work-related impairments with an RFC form. Every disability applicant should submit a completed RFC form unless they cannot obtain one. If you see multiple doctors, you should try to obtain a statement from each doctor.
What Form Does My Doctor Need to Fill Out for Disability?
You can download a generic mental RFC or physical RFC form for free from our website. However, remember that the same forms are used for every claimant, regardless of that individual’s specific impairments. A custom form makes it easier for your doctor to identify physical or mental limitations that only apply to specific medical conditions.
Since each medical condition has specific impairments, we have created custom forms for many conditions. We have physical RFC forms for neck, back, heart, lung, shoulder, knee, hip, foot, fibromyalgia, and migraine headaches. This list is incomplete; we have dozens of forms, including less common medical conditions like dysautonomia and Lyme disease. We also have mental RFC forms for conditions like bipolar disorder and PTSD.
Who Can Fill Out an RFC Form?
A doctor who submits a residual functional capacity form should be a treating physician. A treating physician is qualified to evaluate the claimant’s medical condition and how the condition affects the claimant because the doctor has a history with the claimant.
What Should the RFC Form Say?
Medical opinions only carry weight if they are specific enough to indicate the patient’s limitations and explain why the physician believes the patient is disabled and unable to work. For these reasons, an RFC form should contain the following elements:
- It should identify the claimant’s diagnosed condition(s);
- It should indicate the date of the diagnosis;
- It should indicate the prognosis (or future outlook) for the condition(s) and
- Most importantly, it should identify all the various ways the claimant is functionally limited (which evidences how and why the claimant would be unable to sustain full-time work activities).
Regarding item number four above, it is usually most helpful for a doctor to complete a check-off style form that allows the doctor to address the claimant’s level of impairment. For physical impairments, the doctor may opine as to the claimant’s physical strength level, range of motion, postural or ambulatory limitations (sitting, standing, walking, bending, crouching, reaching, balancing), their ability to lift and carry weight on an occasional or frequent basis, their deficits concerning their senses (seeing, hearing, feeling, grasping, manipulating), and any other physical shortcomings the claimant may have.
If the claimant’s disabling condition is mental, the treating psychiatrist or psychologist should indicate their cognitive deficits. For example:
- Do they have trouble retaining information, learning information, concentrating, getting along with supervisors or co-workers, etc.?
- Does the patient have poor memory, decreased energy, illogical thinking, and so on?
The mental RFC may also indicate the patient’s ability to persist in the areas of concentration and attention, as well as the patient’s ability to interact socially in work settings, assimilate new information, and successfully engage in SRRTs (simple, routine, repetitive tasks).
Ensuring that your RFC form is both timely and accurate is crucial. An outdated or incomplete form can lead to an inaccurate assessment of your limitations and may result in a denial of your claim. Ensure your doctor fills out the form and explains each limitation noted. This will give the claims examiner a clearer picture of your condition and its impact on your ability to work.
Can a Doctor Write a Letter for Disability?
A statement from your doctor can often make the difference between winning or losing your disability claim, but that does not mean any statement will be helpful. The statement should not be too brief to be of any use or too conclusory. I cannot tell you how often our office has received a call from an excited client who says the doctor wrote them a statement that will win the case. It’s usually an extremely brief note on a prescription pad that says little more than “My patient is completely disabled and unable to work.” Unfortunately, this type of statement is useless to the disability claims examiner.
Residual Functional Capacity Forms: Tips for Successful Completion
- Obtain the form from a reputable source.
- Make sure the form is up-to-date and not outdated.
- Ask your doctor to complete the form in its entirety and with detail; avoid vague answers.
- Have the form reviewed by a legal professional for accuracy and comprehensiveness.
Residual Functional Capacity in Long-Term Disability Claims
In long-term disability claims, your residual functional capacity plays a pivotal role in assessing an individual’s ability to work. These assessments serve as a cornerstone for determining eligibility for disability benefits, as they offer a comprehensive overview of how an individual’s impairments impact their ability to work.
Without a clear understanding of an individual’s RFC, assessing the level of support and accommodations they may require to sustain gainful employment becomes challenging. RFC evaluations are critical in vividly portraying an individual’s functional abilities and limitations, allowing for a fair and accurate determination of their eligibility for long-term disability benefits.
Suppose your claim is still within the “own occupation” period. In that case, the LTD disability claims examiner will use your residual functional capacity to determine if you can be expected to do your job. For example, suppose your prior occupation was sedentary, and your RFC is for sedentary work (or higher).
In that case, the claims examiner will likely find you should be able to return to your job unless your RFC identifies further non-exertional restrictions. Non-exertional impairments may include mental or emotional limitations, such as memory problems from a psychiatric or neurological disorder or an inability to concentrate. If your claim is within the “any occupation” period, the claims examiner will review your RFC to determine whether you could return to any occupation in the economy.
RELATED POST: Own Occupation vs. Any Occupation in Long-Term Disability Claims
Factors Considered When Assessing Your Residual Functional Capacity
These assessments consider various factors to provide a comprehensive evaluation. Below are the key considerations in the RFC assessment process:
Medical Evidence and Documentation
In evaluating RFC, medical evidence and documentation are pivotal. This includes reports from treating physicians, specialists, therapists, and any relevant medical professionals. Comprehensive records detailing diagnoses, treatment plans, functional limitations, and treatment responses are crucial for assessing an individual’s ability to perform work-related tasks. Clear and detailed medical evidence substantially strengthens the RFC assessment, providing a solid foundation for determining the individual’s functional capabilities.
Physical Limitations Assessment
Assessing physical limitations is a crucial aspect of the RFC evaluation. This involves gauging an individual’s ability to engage in various physical activities such as walking, standing, lifting, carrying, sitting, and other movements relevant to their potential job requirements. Factors such as range of motion, strength, endurance, and any physical restrictions due to medical conditions are carefully examined to determine the extent of functional limitations impacting the individual’s work capacity.
Mental Health Evaluation
In addition to physical limitations, mental health evaluations are integral to the RFC assessment process. Mental health professionals assess cognitive functions, emotional well-being, and abilities to concentrate, interact with others, and handle work-related stresses. Factors such as anxiety, depression, cognitive impairments, and other mental health conditions are considered when determining the individual’s capacity to sustain employment and perform job duties effectively.
Engaging in ongoing communication with healthcare providers and ensuring all medical evidence is up-to-date and accurately reflects the individual’s functional limitations are crucial steps in the RFC assessment process. By comprehensively evaluating medical evidence, physical limitations, and mental health status, a thorough RFC assessment can provide a detailed understanding of an individual’s work-related capabilities in the context of long-term disability claims.
Residual Functional Capacity in Social Security Disability Claims
The process is slightly different for Social Security Disability claims. Regarding RFC, SSA disability examiners will assess your work capacity by considering your past work experience, age, education level, and medical history. This RFC assessment will then determine if you can return to your past relevant work. If they find you cannot return to past relevant work, they will then determine whether you can perform any other work in the economy.
If You Have More Than One Impairment
Social Security will consider all of your medically determinable impairments of which it is aware, including those that are not “severe,” when assessing your residual functional capacity.
Evidence Social Security Uses to Assess Your Residual Functional Capacity
Social Security will assess your residual functional capacity based on all of the relevant medical and other evidence, such as witness statements and testimonies. In general, you are responsible for providing the evidence Social Security will use to make a finding about your RFC. However, before it makes a determination that you are not disabled, Social Security is responsible for developing your complete medical history, including arranging for consultative examinations (if necessary) and making every reasonable effort to help you get medical reports from your own medical sources.
Social Security will consider any statements about what you can still do that have been provided by medical sources, whether or not they are based on formal medical examinations (such as a functional capacity evaluation). Social Security will also consider descriptions and observations of your limitations from your impairments, including limitations that result from your symptoms (such as pain) provided by you, your family, neighbors, friends, or other persons.
What Social Security Will Consider In Assessing Residual Functional Capacity
When Social Security assesses your residual functional capacity, it will consider your ability to meet the physical, mental, sensory, and other requirements of work, as described here:
- Physical Abilities. When Social Security assesses your physical abilities, it first assesses the nature and extent of your physical limitations. Then, it determines your residual functional capacity for work activity on a regular and continuing basis. A limited ability to perform certain physical demands of work activity, such as sitting, standing, walking, lifting, carrying, pushing, pulling, or other physical functions (including manipulative or postural functions, such as reaching, handling, stooping, or crouching), may reduce your ability to do your past work or even other work.
- Mental Abilities. When Social Security assesses your mental abilities, it first assesses the nature and extent of your mental limitations and restrictions. It determines your residual functional capacity for work activity on a regular and continuing basis. A limited ability to carry out certain mental activities, such as limitations in understanding, remembering, carrying out instructions, and responding appropriately to supervision, coworkers, and work pressures in a work setting, may reduce your ability to do your past work and other work.
- Other Abilities Affected by Impairments. Some medically determinable impairments, such as skin impairments, epilepsy, impairments of vision, hearing, or other senses, and impairments that impose environmental restrictions, may cause limitations and restrictions that affect other work-related abilities. If you have any of these types of impairments, Social Security considers any resulting limitations and restrictions that may reduce your ability to do past work and other work in deciding your residual functional capacity.
In conclusion, your RFC is a critical element in your disability claim, so obtain a detailed RFC form to support your claim. Whether pursuing a long-term disability claim or a Social Security Disability claim, obtaining an RFC form that accurately depicts your medical condition(s) and limitations can significantly improve your chances of winning your case.
A competent and experienced disability lawyer will always try to obtain a completed RFC form. Every client we represent receives at least one RFC form customized to their specific medical condition(s). This is because an RFC form can often “turn the tide” in a case and effectively win disability benefits—call (888) 321-8131 to schedule your free case evaluation today.