Proving Disability: An Overview
To explain residual functional capacity, we should first talk about where it fits in when Social Security evaluates a claim for Social Security Disability benefits. Social Security goes through a five step process to determine whether someone is has a "disability" under the statute. First, Social Security determines whether the Claimant has engaged in "substantial gainful activity." This means working and earning money. If the Claimant is not working and earning money, Social Security looks at the medical evidence to see if a medical condition causes some interference with work ability. If there is, then Social Security looks to see if the Claimant meets an impairment listing. An impairment listing is like a checklist. The Social Security Administration looks at the medical records to see if someone "meets a listing." If the Claimant does not meet a listing, then Social Security determines the Claimant's residual functional capacity.
Residual Functional Capacity
Residual Functional Capacity is what a person can physically and mentally do in a work setting on a sustained basis. Often, a disability claimant's significant medical problems prevent them from returning to their prior work. However, that is only one half of the equation. Social Security must determine whether the claimant, depending on their age, can perform other work that exists in the national economy. To do this, the Social Security Administration reviews the evidence in the claim file to determine a claimant’s residual functional capacity.
For example, a construction worker may have suffered a back injury that prevents him from returning to his prior work. However, that construction worker may still work “light duty” job that does not require climbing, balancing, or heavy lifting.
Why It’s Important
If our construction worker can perform light duty work, then Social Security will determine whether jobs exist in the national economy that this construction worker can physically perform. For example, if Social Security feels the construction worker can still work as a cashier or a security guard, then that claimant will not be found disabled.
How Social Security Determines Residual Functional Capacity
When we review a denied claim, the claims file includes a physician’s evaluation of the medical records. The physician reviews the medical records and other evidence in the file and provides an opinion on the claimant’s residual functional capacity. We often argue that these opinions are speculative and based on limited information. These physicians did not examine the claimant and may not consider what the claimant’s every day activities.
At a hearing, the Administrative Law Judge considers the medical evidence, including other medical opinions, but also the claimant’s testimony, and statements from friends and family. The Judge is not bound by any prior opinions or findings that justified the denial. There also may be new evidence for the Judge to consider.
If you have a denied Social Security Disability Insurance claim, and want to know what extent, contact us. We have nearly thirty years of experience helping disability claimants.