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Residual Functional Capacity: One Piece of the Social Security Disability Puzzle

For hundreds of years, we have amused ourselves with jigsaw puzzles. Did you know the first jigsaw puzzles date back to 1760? That’s hundreds of years we’ve spent trying to fit all the sky pieces together. But jigsaw puzzles still play a role in our lives. For example, Social Security Disability claims can be like a jigsaw puzzle—there are so many pieces that fit within and alongside other pieces, and we have to understand what the pieces represent and how they interlock to see the bigger picture. That’s especially true when we’re talking about a key piece of Social Security Disability like Residual Functional Capacity. 

If your entire Social Security Disability claim is like a puzzle, then Residual Functional Capacity is like a corner section. RFC, as it’s called, forms a foundation for the whole, and it contains smaller pieces within it, but it isn’t the entire puzzle. The best way to understand Residual Functional Capacity, then, is to unpack the pieces that go into it. Beginning with the definition piece, RFC is the highest level of work you can perform despite your impairment. Now, let’s uncover some of those pieces nestled within that definition. 

First, “work.” Work can be physical, as in the bodily effort required for a task. “Work” can also be mental, in aspects like concentration, memory and understanding instructions. Physical “Work” is divided into five levels of job effort that are, in increasing difficulty, sedentary/sitting, light, medium, heavy and very heavy. If you are capable of doing a higher level of work, like “medium,” you are automatically considered capable of doing any lower level too. Mental abilities considered essential in performing “Work” include the abilities to understand, remember and carry out instructions and respond appropriately to supervision, co-workers and to work pressures in a work setting.

Finally, your “impairment” means your actual physical or mental condition, or the limitations on your physical or mental activity brought on by something outside, like pain. Put that together, and RFC is broadly defined as the highest level of physical or mental effort, among the five levels, that your (physical or mental) condition will permit you to do.

But who decides what your RFC is, and how?

Your RFC is determined by a state disability examiner, a consultant for the Social Security Administration, or an administrative law judge, and that person will consider all the evidence you submit. Though SSA may conduct its own physical or mental exam, you can also submit records from your doctor, your own statements about your condition, or statements from family, friends or neighbors. You are responsible for providing as much evidence as possible on your own behalf. 

Remember that RFC is just a corner section of the larger puzzle that is Social Security Disability. RFC comes into play at stage four of a five-stage Sequential Evaluation Process, so let’s walk through each stage of the sequential (in other words, step by step) evaluation process the Social Security Administration uses for your claim.

Stage one considers your work activity, and whether you have engaged in Substantial Gainful Activity (SGA)—Social Security’s definition of “Work.” For the year 2020, Substantial Gainful Activity is defined as earning more than $1,220 a month from work, for non-blind persons. If you have performed SGA, you will likely be deemed Not Disabled and the inquiry ends. 

Stage two considers the severity of your impairment(s), AND whether you’ve had it for more than 12 months. You remember “impairment” from before; “severe” means the impairment “significantly limits” your physical or mental ability to work for a period of at least one year. If the answer at this stage is “no,” you are found Not Disabled and the process stops.

Stage three considers whether your impairment is listed on Social Security’s master list of qualified impairments. If both answers are “yes,” you are deemed Disabled and the inquiry stops.

If not, stage four considers your Residual Functional Capacity along with your ability to do “past relevant work,” which is basically your former jobs over the preceding 15 years. If you can do any of those jobs based on your RFC, you’re deemed Not Disabled; otherwise, you move to the final step. 

Stage five packs your RFC, along with your age, educational level, prior work experience and level of transferable skills, into a “medical-vocational grid.” There is a different grid for each of the five “job effort” levels we discussed earlier—sedentary, light, medium … see how all the pieces are fitting together?

In terms of the grid, the older you are, the more likely you’ll be deemed “Disabled.” That’s because Social Security believes it’s more difficult for older people to adjust to new work. Consequently, those age 49 and younger often find it more difficult to be deemed Disabled, although your level of education and work history play a part as well.

Even if the facts of your case do not fit in one of the medical-vocational grids, it is possible that the decision-maker can find you Disabled because, for example, you could not dependably work a full-time job.Now you know how some of the pieces of the Social Security Disability puzzle fit together. If you need help understanding the 5-step sequential evaluation and how Social Security will review your claim, contact Clauson Law today.

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