Important: We updated this article in June 2023 to make sure all info below is both current and correct. Want to know how the Social Security Administration (SSA) decides you can’t work for one year due to a disability? Surprisingly, the Residual Functional Capacity (RFC) form holds the most weight in proving that you medically qualify for disability benefits. We’ll explain why this document is key for getting Social Security disability benefits.
New Social Security rules went into effect in March 2017 that changed which evidence matters most in getting benefits. Before that, you could ask your doctor to write a medical opinion letter on your behalf. That letter could outline what physical, mental and emotional limitations your condition causes that fit the SSA’s definition of disability.
You would also include your medical records, along with any non-AMS provider opinions from people that could help support your claim. (A non-AMS provider is anyone who the SSA doesn’t consider to be an Acceptable Medical Source, such as a group therapist.) Since your own doctor’s opinion doesn’t count more than a Disability Determination Services (DDS) doctor’s does, what should you do? Keep reading…
What Does “Residual Functional Capacity” Mean?
You need medical evidence that proves your health makes you unable to work for at least 12 months. First, the SSA needs to know what you currently can or cannot do, specifically because of your health problems. Before your health issues began, you were physically, mentally, and emotionally able to work at your full Functional Capacity (FC). Your health problems hurt that functional capacity in some way. For many people, that loss could be both invisible and difficult to prove. Your residual functional capacity defines what you can still do and what is now impossible because of your health. Assessing your residual functional capacity tells the SSA if you’re still able to do certain work tasks. It also tells the SSA whether your health prevents you from any gainful employment for at least 12 months.
First, DDS looks at the most recent 15 years you worked. This tells the SSA what type of jobs you know how to do. Then, the SSA reviews your residual functional capacity assessment to see whether you can work. It’s best to have your doctor complete the mental and physical forms we linked below, if you can.
Important: If a specialist treats you for several months before you apply, you’ll greatly increase your odds of winning benefits.
How the SSA Determines Your Residual Functional Capacity If Your Doctor Doesn’t Fill Out Those Forms
In order to assess your current ability to function on a daily basis, a claims examiner works with a DDS medical consultant. (DDS is a state agency that works for the SSA.) Together, they fill out your residual functional capacity forms if your doctor didn’t do so already. Then, they conduct the RFC assessment on your disability claim. The consultant also uses your medical records to determine how much your health affects your exertion levels.
They also look at any restrictions that could limit your job opportunities or specific work tasks due to your health. Once they get the full picture, the final assessment constitutes your residual functional capacity that goes back to the SSA.
The reason a DDS medical consultant and claims examiner complete your RFC assessment together is pretty straightforward. No judge or claims examiner can tell whether you can work or not from looking at medical records. They aren’t doctors, so the SSA assigns two people with the right experience to determine your residual functional capacity. Once that’s complete, the SSA’s claims examiner or a judge can approve or deny your disability claim.
RFC Form #1: Measuring Your Physical Limitations
First, the SSA needs to know how much physical activity you can do to assign an exertional work level. That assessment requires a Physical Residual Functional Capacity (PRFC) form. Those work levels are as follows:
- Sedentary. You can sit, stand, walk, and occasionally lift 10 pounds or less if needed. Mostly, you’ll work sitting down.
- Light. You can sometimes lift up to 20 pounds, and regularly lift no more than 10 pounds. You can frequently walk, stand, push and pull using your arms or legs along with any sedentary job duties.
- Medium. You can frequently lift or carry no more than 25 pounds, and occasionally lift up to 50 pounds. You can also perform light or sedentary job duties.
- Heavy. You can often lift and carry things weighing up to 50 pounds, and occasionally lift objects weighing no more than 100 pounds. This level also includes all medium, light and sedentary job duties.
- Very heavy. You may sometimes lift objects that weigh at least 100 pounds and often lift or carry 50-pound items. You can also perform job duties in all other levels seen here.
If your physical RFC level matches your job’s daily demands, then the SSA says you can work. However, your physical RFC form may list other issues that impact you. If the SSA decides you can still work, they’ll say so in your denial letter.
They also look at any non-exertional restrictions, including:
- Whether you can pick up a dropped pencil without help (i.e., stooping, kneeling)
- Using your hands and fingers on the job (i.e., sensory, gross, and fine motor skills)
- Vision loss or sight issues
- Communication issues (i.e., hearing, speaking)
- Having to avoid extreme heat or cold temperatures
RFC Form #2: Measuring Your Mental Health-Related Limitations
If you file a disability claim for mental health reasons, then by law, the SSA must investigate your reported symptoms. If they’re severe enough, you’ll have to submit a Mental Residual Functional Capacity (MRFC) form.
Measuring your physical RFC is pretty easy to do (i.e., you can or cannot lift, push, carry, pull). Unfortunately, figuring out your true mental residual functional capacity is much harder. For a mental RFC determination, the SSA looks at current job opportunities across the U.S. They do this to find less mentally demanding jobs that you may be able to do. If you can’t handle even simple, unskilled jobs, then you may qualify as disabled. When that happens, the SSA usually awards you benefits. But first, the SSA needs to fully understand your mental and physical residual functional capacity levels.
A mental RFC assessment measures (but isn’t limited to) how well you currently can:
- Understand, remember, and follow spoken instructions
- Recall locations, work procedures, and routine job tasks from memory
- Pay attention and concentrate on tasks for long periods of time
- Meet scheduled deadlines
- Show up to work on time
- Work directly with or next to others without becoming distracted
- Interact appropriately with the public
- Respond appropriately to your manager’s direction and feedback
- Follow socially acceptable standards of neatness and cleanliness
- Adapt to changes in the workplace
- Notice standard workplace hazards and respond appropriately
- Tolerate normally expected stress levels
- Drive yourself to and from work, or use public transportation
- Set realistic goals and make plans without help from other coworkers
Why Your Doctor Should Fill Out Your Residual Functional Capacity (RFC) Form
Some conditions can cause symptoms that aren’t obvious to others, but would qualify you for SSD benefits. If you’re diagnosed with an invisible or hard-to-prove health issue, have your doctor fill out your residual functional capacity forms. Here are a few examples that help show what we mean by this:
- You come home from work and realize you were robbed. After a few days, you see a doctor because you’re having panic attacks. Your doctor diagnoses PTSD and prescribes medication. Due to your PTSD, you have difficulty leaving the house for work. You may qualify for monthly disability — if you can prove it.
- You got rear-ended. When you go to work, you cannot type for more than a few minutes. Your hands shake, and after an X-ray, your doctor says you need physical therapy. Except for some bruises, you look fine — but cannot sit and type. So, you may qualify for SSDI.
- While moving, you hurt your back carrying furniture. You pop a Tylenol and hope it gets better in a few days, but it doesn’t. Finally, you ask your doctor for pain medication. After your exam, the doctor warns you not to lift anything due to a pinched nerve. You work for a package delivery service and bartend at night, but can’t do either job in such pain. Proving you qualify for disability may be harder than you think.
Have your doctor fill out both RFC forms explaining how and why your health makes working impossible. A specialist is ideal, but the person treating you now understands your condition(s) far better than the DDS will.
How to Get Free Expert SSD Claim Help
A Social Security attorney can answer your questions about residual functional capacity and help you file for free. And you’re nearly 3x more likely to get benefits if a disability lawyer handles your claim.
These attorneys always work on contingency. This means you pay $0 for claim help if the SSA doesn’t award you benefits. And if you win, then you’ll only pay one small fee out of your back pay. Those who qualify for expert claim help through this website usually get $13,800 in back benefits plus monthly payments.
Want free expert claim help? Click the button below now to start your free online benefits quiz and see if you may qualify:
Lori Polemenakos is Director of Consumer Content and SEO strategist for LeadingResponse, a legal marketing company. An award-winning journalist, writer and editor based in Dallas, Texas, she's produced articles for major brands such as Match.com, Yahoo!, MSN, AOL, Xfinity, Mail.com, and edited several published books. Since 2016, she's published hundreds of articles about Social Security disability, workers' compensation, veterans' benefits, personal injury, mass tort, auto accident claims, bankruptcy, employment law and other related legal issues.