If you have applied for Social Security disability benefits or are thinking about doing so, there are a number of obstacles you might encounter on your way to getting approved. The purpose of this message is to explain some of the rules or concepts the Social Security Administration (SSA) uses to evaluate your claim and how to avoid one of the more harmful potential pitfalls in the process.
SSA puts a lot of emphasis on something called ‘Residual Functional Capacity’ (RFC). An individual’s RFC is his ability to do physical and mental work activities on a sustained basis despite limitations due to medical problems. In other words, are you capable of performing heavy physical activities, medium, or any at all? The answer to this question is very important because the SSA assumes that there are certain numbers of jobs nationally within different levels of physical capacity. Generally speaking, the greater your physical capacity, the less likely it is you will meet the requirements for disability under the Social Security Act.
Therefore, you must avoid being locked into an RFC which is unrealistic. Unfortunately, in the early stages of the claims process, SSA relies heavily upon the opinions of consulting physicians who have no hands-on treatment of you. The majority of the time these opinions of people who don’t know you are not helpful. In many instances, these consulting physicians only look at a portion of your records. Reliance upon such medical sources is doubly frustrating because your treating physicians often lack the time to complete paperwork necessary to help explain the true picture.
How should you deal with these obstacles?
First and foremost: retain an attorney who is well familiar with the requirements of the Social Security Act. Your representative can obtain all pertinent medical records and make sure that these become part of your file. Thus, if a non-treating medical expert offers an opinion without considering all of your medical records; his opinion against your interest will lack credibility and can be rejected.
Next, your representative can make a persuasive argument to the administrative law judge reviewing your claim based on your treatment notes and other medical sources, that you cannot perform certain activities on a “sustained” basis. That is, while you ‘might’ be able to lift a certain amount of weight on an occasional basis or on a good day, you are not reliable to lift it throughout a typical work week. Do not take for granted that factors such as the effects of medicine or other limitations you might have will be given the necessary consideration without emphasis.
Lastly, don’t take no for an answer. The process of evaluating your claim will likely be a long one, and if it first you don’t succeed in getting your doctor’s ear, then try again. Every effort should be made by you and your attorney to obtain a rationalized opinion by your treating doctor which explains your restrictions and limitations. The judge reviewing your claim wants and expects opinions from your treating doctors because it helps him or her to make the right decision. Even though your doctor might not have time to write a book about you, he might be willing to give a short and simple statement on a prescription pad or office stationary which explains your limitations.
Avoiding the wrong conclusion about your RFC could make the difference between winning and losing.