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Measuring Disability: Understanding Residual Functional Capacity Tests

Posted Scott B. Cooper on Dec 10, 2013 in Social Security Disability

The statistics on disability in the United States are grave. About one in every six working-age Americans has some sort of disability that hampers everyday activities. Fortunately, most of these disabilities are relatively minor, making it harder but not impossible to work.

But many Americans have chronic disabilities so severe that they can no longer hold down their jobs—or work in any other capacity. For them, Social Security Disability Insurance (SSDI) can provide an essential lifeline.

SSDI is not welfare – It’s an insurance program that workers qualify for by automatic payroll deductions. If someone has worked long enough and recently enough to be eligible, he may choose to apply for federal SSDI benefits after becoming disabled. A critical part of this application process is proving that one’s ailment or condition meets the Social Security Administration’s standards for disability.

The Importance of the Residual Functional Capacity Assessment

In Pennsylvania, each application for SSDI benefits is passed to the Bureau of Disability Determination, a division of the state Department of Labor and Industry. Other states have similar offices that work hand-in-hand with the Social Security Administration. The Bureau of Disability Determination has the duty to examine every SSDI claim and decide whether the applicant actually qualifies as disabled under Social Security Administration rules.

The most straightforward applications are those with diagnoses that match up with the Social Security Administration’s list of impairments. This is a list of over a hundred specific ailments and conditions, along with particular symptoms, that have frequently been found to be disabling in the past. For example, listing 8.04 specifies “Chronic infections of the skin or mucous membranes, with extensive fungating or extensive ulcerating skin lesions that persist for at least three months despite continuing treatment as prescribed.” If an applicant’s diagnosis falls within that description, he is likely to be considered disabled.

The human body can fail in many more ways than are mentioned in the Social Security lists. Most people who will apply for SSDI benefits don’t fit neatly into one of these categories. They will have to prove they are disabled by undergoing a residual functional capacity (RFC) assessment. This may require an examination by a Social Security-approved physician.

The purpose of the RFC exam is to determine the applicant’s ability to perform physical and mental tasks that may be commonly encountered during employment. The medical records submitted in the application process will be the foundation for the residual functional capacity evaluation. The review will decide whether the applicant is capable of performing heavy work, moderate work, light work, or sedentary (seated) work. If the RFC assessment finds that the applicant can’t even perform sedentary work, he will be confirmed as disabled.

The RFC Test Isn’t the End of the Line

If you have applied for Social Security disability benefits in Pennsylvania and have been asked to undergo a residual functional capacity exam, that does not mean you will be ineligible for benefits. Even if the RFC test says you can perform light or sedentary work, you still may qualify for SSDI if you have no prior work experience or skill in those jobs. Unfavorable RFC tests results can be challenged in the appeals process.

At Schmidt Kramer, we regularly fight to secure crucial SSDI benefits on behalf of our clients from Carlisle, York, Harrisburg, Lebanon, and other surrounding communities. Our disability benefits lawyers in Harrisburg understand what examiners are looking for at the Bureau of Disability Determination, and we can help you make the case for the income you need when you aren’t able to work. Call us at 717-888-8888 or 888-476-0807 toll-free to have your questions answered or to arrange for a free, confidential case review.