Thursday, November 06, 2008

RFC Form for Social Security Disability or SSI Case

A while back I made a free download available on the homepage of for an RFC form. RFC stands for something known as residual functional capacity and the term basically refers to what level of functionality a person possesses. When a person files for disability, the disability examiner who handles the case will have the task of determining what their RFC is. This is basically where the decision on the case gets made because the RFC assessment will determine A) whether or not the applicant can return to to their past work and B) whether or not the applicant can perform some type of other work.

An RFC assessment is made by reading an applicant's medical records and then ascertaining both what the person is no longer capable of doing and, at the same time, what they are still capable of doing. For example, an RFC assessment will address a person's ability to lift a certain amount of weight, their ability to use their hands, their ability to stoop or to crouch. It can also address non-physical functional considerations such as the ability to concentrate, persist, learn, and remember. Not surprisingly, RFC assessments of what a person can and can no longer do are made on something called an RFC form.

However, what may be surprising to anyone who has never worked inside the disability system (I'm a former disability examiner myself) is that social security never sends an RFC form to an applicant's own doctor. Instead, they have one of their own doctors---referred to as a medical consultant and assigned to a case processing unit with disability examiners---complete the RFC (which may, depending on the nature of the impairment, be a mental RFC or a physical RFC).

While this may seem reasonable to some, consider the following facts:

1. Social Security doctors, i.e. medical consultants who work alongside disability examiners, work for social security. This is a redundant statement, but the purpose is to drive home a point. These doctors are not necessarily objective.

2. A social security doctor has never met nor treated the disability applicant that he or she will complete an RFC form on.

3. The vast majority of all disability applications---and social security doctors are involved in these cases---are denied.

Now, consider this---wouldn't it make more sense for social security to send an RFC to the claimant's own doctor, particularly since this doctor has actually seen and treated the claimant? It certainly would. It might also mean that more claims would be approved.

At the hearing level, of course, where the decision-maker is a disability judge and the claimant is often represented, a good disability attorney will have obtained a completed a RFC form from the claimant's doctor or doctors. And very often an RFC form at this level will have the notable effect of winning the case. Simply because disability judges respect the opinions of treating physicians and a claimant's treating physician is not in the employment of the social security administration.

RFC forms tend to produce the best benefit at the hearing level. However, in certain cases, they can definitely improve one's chances of winning disability benefits at the disability application level.

Return to the Social Security Disability SSI Benefits Blog

Other Posts

What is the difference between Social Security Disability and SSI Disability ?
Do disabled children qualify for benefits?
Approved for Social Security Disability after the Medical Exam
If you already receive social security disability or ssi benefits, can you work ?
SSDI and working -- or not working
How to get Approved for Disability Benefits - Information on disability claims

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Blogger madkevinp said...

I used the forms for both doctors (Psychiatrist, And Medical). It took a little effort on my part to have them fill it out but I believe this is one reason I was approved in (what I think is an astonishing time) of 107 days. As I stated before I used most if not ALL of your secrets to my advantage. Thank You once again, KevinP Madkevinp

5:24 AM  
Blogger Dave said...

I agree totally with Tim. The CE process (Consultative Exam) process was, and is, patently flawed. As a claims rep, and then in management for years at SSA, it was always a tricky task telling claimants that your application for Disability (SSDI or SSI) was denied based on the exam of a doctor you saw only once. I was asked many times how this assessment could override the records of a doctor that person had seen for many years. Allowing the person's regular doctor or specialist makes perfect sense, would probably create many more allowances at the initial claims level and thus preclude adding to the mammoth hearings backlog. But alas, will SSA make such a practical change, that is the question....
This is where some good systems advocacy might help, and with a new Administration, that I believe will be more responsive to the needs of the disabled, we need to take action!

12:33 PM  

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