What is a Residual Functional Capacity Form? Residual functional capacity (RFC) forms can help support your Social Security disability claim. RFC forms explain how your symptoms impact your ability to perform work activities. Social Security does not award benefits on your diagnosis alone. Therefore, you must show that your medical conditions keep you from being able to work.
What is my residual functional capacity?
Residual functional capacity (RFC) is defined as the most you can do despite your medical impairments. An RFC can include both mental and physical limitations. Your RFC is very important. First, Social Security looks at whether your condition meets one of the medial listings. Most conditions won’t be severe enough to meet one of the medical listings. Therefore, Social Security needs to look at your residual functional capacity.
How does Social Security use residual functional capacity forms?
An RFC form helps Social Security understand how your conditions impact your ability to perform activities. The forms are used by SSA’s Disability Determination Services (DDS) office to process your claim. A Social Security medical consultant reviews your medical records. They complete an RFC form based on the information they have. Additionally, they will provide an explanation for their findings. Next, Social Security looks at whether or not your RFC lets them approve your claim.
Physical Residual Functional Capacity forms
A physical RFC form includes questions about your ability to do things like:
How long you can sit, stand or walk at one time or in an 8 hour work day
How much weight you can lift or carry
If you need an assistive device such as a cane, walker, wheelchair or crutches
Using your arms and hands for activities such as reaching, pushing, pulling, gripping or grasping objects
If pain, fatigue, other symptoms or side effects from medications cause limitations with concentration, persistence or pace
Mental Residual Functional Capacity Forms
A mental RFC form includes questions about your ability to do things like:
Your ability to understand, remember or carry out instructions or interact with others such as supervisors, co-workers or the general public
Your ability to maintain attention and concentration
If your symptoms interfere with your ability to show up to work, arrive on time or have to leave early
Residual Functional Capacity forms for your doctors
Your treating doctors may also complete an RFC form. Having your doctor complete an RFC form can be very helpful. After all, they should know more about your health than anyone else. An RFC form should be very detailed. It should include all your medical symptoms and conditions. It should also include all of your treatment and any side effects from medications.
The importance of residual functional capacity forms
Social Security considers more than just your diagnosis. They need to understand how your conditions affect your functioning. Therefore, even if you think your medical evidence is strong, RFC forms can help strengthen your case. Many times, medical records do not clearly translate how your symptoms impact your functioning. Specifically, your doctor’s RFC form can:
Provide your treating doctor’s opinion about how significantly your conditions impact your functioning
Provide your doctor’s opinion in the specific way Social Security evaluates functioning
Can help win your disability case especially if you are appearing before an Administrative Law Judge
How a residual functional capacity form can help win your case
Social Security considers your age, education and work background when evaluating your claim. If you are under the age of 50, you must show that you cannot work at all. Social Security will consider other types of work, not just the work you have done in the past. An RFC form can help explain why you may not be able to work on a full time basis.
Example 1: Residual functional capacity forms
For example, say you are under the age of 50 and worked before as a cashier. You have a back injury that interferes with your ability to do this type of work. You also have side effects from your medications that make you drowsy. In an RFC form, your doctor states that you cannot sit for more than 4 hours or stand or walk for more than 2 hours in a work day. Your doctor also states that you have problems with attention and focus due to your medications. These limitations help support your disability claim because it shows that you could not work a full 8 hour day.
Residual functional capacity forms and the Grid Rules
Social Security recognizes that it may be harder for older individuals to learn new work. Therefore, there are more favorable rules for people 50 or older. These rules are known as the Grid Rules. They are even more favorable if you are 55 or older. Essentially, the Grid Rules consider your age, education and work background. If Social Security finds that you can’t go back to work you’ve done in the past 15 years, you might be disabled.
Example 2: Residual functional capacity forms and the Grid Rules
For example, Ellen, a 53 year old woman previously worked as a cashier. She filed for disability because she developed osteoarthritis in her knees. She can no longer stand or walk for long periods of time. In an RFC form, her doctor stated that shecould not stand or walk for more than 2 hours a day but can sit for at least 6 hours a day. Her doctor also reported that she needed a cane when walking. She cannot work as a cashier. Even though she can do seated work, the Grid Rules allowed Social Security to approve her case.
Example 3: Residual functional capacity forms and the Grid Rules
In another example, Adam, a 57 year old, previously worked as a janitor. His job required him to lift and carry over 50 pounds occasionally. Adam injured his back and can no longer perform his job duties. In an RFC form, Adam’s doctor reported that Adam could not lift more than 20 pounds. He also reported that Adam could only stand or walk for 4 hours a day. Even though Adam could do other work, the Grid Rules allowed Social Security to approve his case.
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What Are Non-Medical Requirements for Disability? To receive Social Security disability insurance benefits (SSDI) or Supplemental Security Income benefits (SSI) you must meet both medical and non-medical requirements. Typically, Social Security will make sure you meet the non-medical requirements before looking at the medical requirements.
General Non-Medical Requirements for Disability
The non-medical requirements for disability include any criteria not related to your medical or mental health conditions. This includes your proof of age. Generally, you can use your birth certificate as proof of age. Social Security will also ask you questions about your marital status and children.
Non-Medical Requirements for Disability and Work Status
Additionally, Social Security will also need to confirm that you are no longer working. Social Security defines disability as having medical conditions that keep you from working. Your conditions must keep you from working for at least 12 months. Therefore, if you are still working full time or are out of work for less than 12 months, you would not qualify for Social Security disability benefits.
Non-Medical Requirements for SSDI
In order to qualify for SSDI benefits, you need to have worked a certain number of years. Any worker with a valid Social Security number who paid into Social Security may file for SSDI benefits. Social Security keeps track of your earnings and work credits. You receive work credits each year that you work and pay taxes. Generally, you need at least 20 work credits to qualify for Social Security disability benefits.
Non-Medical Requirements: SSDI Work Credits
Social Security disability work credits expire after a certain amount of time after you stop working. Your date last insured (DLI) is the last date you can qualify for SSDI benefits. Usually, your DLI covers five years after you stop working. However, your coverage may end in less than five years if your earnings were low. Your coverage may also be limited if your work was inconsistent.
Example : SSDI work credits
As an example, say you stopped working in June 2019. You worked consistently for the past 12 years. Your date last insured would expire around June 2024. Therefore, you are currently eligible to file for Social Security disability benefits.
Non-Medical Requirements: Expired DLI
You can still apply and qualify for SSDI benefits if your DLI has expired. However, you must prove that you were disabled before your DLI expired. Sometimes, this can be very difficult. The longer you wait to file for SSDI after your DLI expired, the harder it can be to prove your case.
Example: SSDI expired DLI
For example, Donna stopped working in June 2013 when her fibromyalgia symptoms became worse. She did not file for Social Security benefits until December 2019. Her DLI expired in June 2018. Donna must have medical evidence showing that her condition prevented her from working before June 2018.
Non-Medical Requirements for SSI
Supplemental Security Income is a financial needs-based program. To qualify for SSI, Social Security considers your income, assets and resources. Unlike SSDI, you do not need to have worked or earn any work credits. Both children and adults can file for SSI. However, Social Security looks at the income of the parents for children’s SSI eligibility.
What are the Financial Requirements for SSI?
SSI benefits have a very strict set of financial requirements. It is considered a “means-tested” benefit. To meet the SSI income requirements,
You must have less than $2,000 in assets (or $3,000 for a couple)
Have a very limited income
Are a US citizen (there are very few exceptions to this)
Can You File for Both SSDI and SSI?
In some cases, you can file for both SSDI and SSI. You may have earned enough credits for SSDI. You may also meet the financial requirements for SSI. Filing for both SSDI and SSI is referred to as filing for “concurrent benefits.” However, to receive concurrent benefits, you must be approved medically for SSDI but receive low monthly payments.
Example: non-medical requirements for SSDI and SSI
For example, you have worked consistently in the past. Unfortunately, you have had to stop working due to your medical conditions. Now that you are no longer working, your income is very limited. You may have to apply for state assistance or file for SSDI/SSI or rely on others for financial help.
Technical Denials
If you do not meet the non-medical requirements for disability, you will receive a technical denial. Social Security will send you notice of a technical denial pretty quickly. You cannot appeal a technical denial.
Medical Requirements for Disability
If you meet the non-medical requirements for disability, Social Security evaluates the medical requirements. Your claim will be sent to Disability Determination Services (DDS.) DDS contacts your doctors for you medical records. They may schedule examinations with a Social Security consultative examiner. DDS will determine whether you are medically disabled.
Getting Help with your Disability Claim
Working with an experience advocate can be beneficial. It can help improve your chances of winning your case. Your disability advocate understands both the medical and non-medical requirements for Social Security disability claims. They can help guide you through the process.
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Autism Disability Allowance, Social Security considers autism and autism spectrum disorders as potentially disabling conditions. Autism can cause problems with social functioning and affect your ability to communicate with others. You or your child may qualify for Social Security disability benefits for autism.
Autism Disability Allowance for Adults and Children
Adults may apply for Social Security disability insurance benefits (SSD). They may also apply for Supplemental Security Income (SSI). Unlike adults, children can only apply for SSI benefits. You must have earned enough Social Security work credits to apply for SSD benefits. Unlike SSDI, you do not need to have worked to file for SSI. However, you must meet certain financial requirements. Social Security looks at parents’ income for children’s SSI benefits. Unfortunately, a disabled child can’t apply for SSI if their parents have too much income.
Autism Disability Allowance for Disabled Adult Children
Adult children could qualify for SSD benefits based on their parent’s earnings record. Social Security considers someone a disabled adult child if:
You are over the age of 18
Not married
Disability that began before you were 22 and one of your parents receives Social Security benefits or is deceased
Social Security Disability: Autism Spectrum
Social Security evaluates claims using the “Blue Book”. The Blue Book includes a listing of impairments. Generally, to qualify under the Blue Book, you must meet certain conditions. Social Security considers autism under listing 12.10 for adults and 112.10 for children.
Social Security’s Listing 12.10 and 112.10 “Autism spectrum disorder”
First, the listing requires that you have all of the following documented in your records:
Problems in verbal and nonverbal communication
Problems in social interaction
Significantly restricted, repetitive patterns of behavior, interests or activities
Second, you must show one extreme limitation or two marked limitations in the following areas:
Understanding, remembering or applying information
Interacting with others
Concentrating, persisting or maintaining pace
Adapting or managing oneself
“Marked” means having a serious limitation in that area of functioning. “Extreme” means not being able to function in that area at all.
What if my child’s autism doesn’t meet the listing?
Your child’s autism may not meet the disability listing. Fortunately, Social Security can still approve them for benefits another way. Social Security will consider all of your child’s limitations. Specifically, they look at six areas of functioning or domains. Your child still must have at least one extreme limitation. Alternatively, they can have two marked limitations. These areas of functioning include:
Acquiring and Using Information – how your child understands and remembers information, learning new information and recalling and applying previously learned information
Attending and Completing Tasks – how your child pays attention, follows instructions, taking turns, finishing class work or homework, working at a reasonable pace
Interacting and Relating with Others – how your child plays with other children, expresses anger, takes turns, understands body language and social cues
Moving About and Manipulating Objects – how your child manages physical activities such as standing, balancing, running, jumping, using their hands and hand-eye coordination
Caring for Himself or Herself – how your child handles frustration, takes care of personal hygiene, avoiding dangerous circumstances, and responding to changes in their mood
Health and Physical Well-being – specific medical conditions like asthma or depression, side effects from medications or other symptoms or anything else that would cause problems functioning
What you need for an autism disability allowance
Social Security needs evidence to evaluate your child’s functioning. Evidence includes records from pediatricians, therapists and other medical professionals. Often, Social Security asks your child’s teachers to complete a questionnaire. Social Security can also consider other evidence. For example, attendance reports, report cards and other school documents might be helpful. This may include Individual Education Plans or IEPs. Your disability advocate will tell you what evidence would be helpful.
Autistic Disability Allowance for Adults
If you don’t meet the listing, Social Security considers your residual functional capacity (RFC). Your RFC is what you can do despite your symptoms. Particularly, Social Security looks at how your autism affects your ability to work. Therefore, you have to show how your conditions keep you from working.
Autism and your RFC
Proving disability in autistic adults can be challenging. This can be especially true if you have worked in the past. However, the right documentation can support your case. Your doctor should complete an RFC form. Your doctor can help explain how severe your symptoms are. There are also agencies that help disabled adults. For example, evaluation from the Department of Vocational Rehabilitation (DVR) can explain the problems you are facing in the work place. DVR helps place disabled adults in jobs. Therefore, they can provide specific limitations you would have at work.
Disability Help Group: Winning Autism Disability Allowance Case Study
For example, John is 23 years old, diagnosed with autism. He was in special education classes in school. He has not been able to work. John tried filing for SSI benefits due to his autism. Unfortunately, he was denied. He then turned to Disability Help Group for help. On his advocate’s advice, he talked to his doctor. His doctor provided an RFC form explaining John’s problems interacting with others and his problems concentrating. His advocate was also able to get John’s school records, including his IEPs. John had some testing with his local DVR. The testing showed that John could not perform any job duties without close and frequent supervision. Social Security determined that John could not work in full time competitive jobs. As a result, he was approved for Social Security disability.
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Related Articles to Can’t Work Due to Anxiety and Depression
How Do I Check My Social Security Disability Work Credits? The Social Security Administration keeps track of your earnings and work credits. They do this by using your Social Security number. Social Security provides this information on your Social Security Earnings Statement. It is available to everyone age 25 and over. Social Security mails out your statement periodically. You can also look at your statement online. You would need to create an online account with Social Security. Occasionally checking your estimated Social Security benefits lets you to check for any mistakes on your record.
What are Social Security Disability Work Credits?
Work credits are credits that you earned during your work history. You receive work credits each year that you work and pay taxes. Unfortunately, Social Security can’t pay you benefits if you don’t have enough work credits. These credits are required to receive Social Security disability benefits (SSDI), retirement benefits and Medicare. However, you do not need work credits to file for Supplemental Security Income (SSI). To file for SSI, you need to meet certain income requirements.
How do I earn Social Security disability work credits?
Work credits are based on your total wages and self-employment income for the year. At most, you can earn four work credits per year. The amount of earnings it takes to earn a credit can change from year to year. In 2020, you must earn $5,640 to get four credits for the year. How Can I Check My Social Security Disability Credits?
How many work credits do I need for Social Security Disability benefits?
Generally, you need to earn a total of 20 work credits to qualify for Social Security disability benefits. Typically, Social Security will look back ten years from the date you filed your disability application. You must have worked at least five of those years to qualify. However, there are some age exceptions. If you are younger, you may qualify for Social Security disability benefits with fewer credits. For example:
Before age 24 – you need to earn 6 credits or have worked 1.5 years
Ages 24-30 – you need to earn 8-18 credits or have worked 2-4.5 years
Ages 31 or older – you need at least 20 credits in the 10 year period before you became disabled
Do my Social Security disability work credits expire?
Additionally, in order to be eligible for Social Security disability benefits, you must meet a recent work test. After you stop working, you do not have an indefinite time to file for disability benefits. Like other insurance program, your coverage ends after a certain amount of time from when you stop working. How Can I Check My Social Security Disability Credits?
How Does My Date Last Insured Impact My Disability Work Credits
Your date last insured (DLI) is the last date you can qualify for Social Security disability benefits. Your DLI depends on when you last worked. Usually, your DLI lasts five years after you stop working. However, if your earnings were low or your work was inconsistent, your DLI may be less than five years.
Example 1: Date last insured
Bob stopped working in December 2014. He had worked for seven years as an auto mechanic. While he was out of work, Bob fell and injured his neck and shoulder in February 2019. He no longer could work. Bob’s date last insured expires in December 2019. Since Bob’s DLI expires after he became unable to work, he can still qualify for Social Security disability benefits. How Can I Check My Social Security Disability Credits?
Example 2: Date last insured
Gina stopped working in June 2018 after she needed knee surgery. She had worked for over 10 years as a home health aide. She was unable to return to work after her surgery. Gina’s date last insured would not expire until around June 2023. Therefore, she is currently eligible to file for Social Security disability benefits.
What if my DLI has expired?
You can still file for Social Security disability benefits if you stopped working more than five years ago. However, you would need to show that you became disabled before your DLI expired. You must have medical evidence that shows you couldn’t work before your DLI. Sometimes, this can be very difficult. Older medical records might not be available. You may not remember all of the doctors that treated you. How Can I Check My Social Security Disability Credits?
Work with an experienced disability advocate to make sure your Social Security disability work credits are correct
An experienced disability advocate can really help in these situations. Your disability advocate can help you understand these complicated issues. They can help you gather the medical evidence you need to win your case. Frequently, if your DLI has expired, you may need to go to a Social Security disability hearing to decide your case. Your disability advocate gets your ready for your hearing. They also make sure the judge has everything they need to decide your case. How Do I Check My Social Security Disability Work Credits?
Disability Help Group: Winning Case Study
George stopped working in 2013 because he had a car accident. Unfortunately, he was unable to go back to work. He suffered from chronic back pain. George didn’t know he could file for Social Security disability benefits when he stopped working. He contacted Disability Help Group for assistance in 2019. At that time, his date last insured had expired in December 2018. George had to go to a disability hearing. We were able to help George provide all of his medical records to the judge since his accident. Therefore, George was able to show that his medical conditions kept him from working before his DLI. He was approved for benefits.
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Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.
Social Security over 55 Grid rules are special disability rules that can help you win your case.
Social Security Over 55 Grid Rules
It is much easier for Social Security to approve your application for disability benefits if you are over age 55. Typically, for disability benefits, you have to show that you can’t work. If you under age 50, you have to show that you can’t do any kind of work at all. As you get older, there are more favorable rules Social Security can use to approve your case. That’s because Social Security understands that it may be harder for older people to do new types of work. These rules are the “grid rules.”
The grid rules consider different factors. These factors include:
Age
How far you went in school
Work background
Residual functional capacity (RFC) – what you can do despite your medical conditions
The Grid Rules and Your Past Work
Social Security will look to the grid rules once they have figured out your residual functional capacity (RFC). In order to apply the grid rules, Social Security must categorize your past work. The grid rules will only apply if Social Security finds that you can’t return to your past work. Social Security only considers past relevant work. Past relevant work is work done in the past 15 years. It should also have resulted in significant earnings. Temporary or part-time jobs might not count as past relevant work.
Social Security has different physical categories of work. These include:
Sedentary – mostly sitting jobs that don’t require lifting more than 10 pounds
Light – usually require more standing and don’t require lifting more than 20 pounds
Social Security will also look at the type of skills required to do your past work. Sometimes, there are skills from your past work that can be used to do different types of jobs. Social Security calls them transferable skills. It is harder to apply a favorable grid rule when there are transferable skills. However, transferable skills won’t apply if you can only do simple, routine tasks. Generally, Social Security makes this finding when there is treatment for mental health problem.
Applying Social Security Over 55 Grid Rules
Case study 1: Over 55 Grid Rules
For example, a 58 year old man applied for disability because he had coronary artery disease, hypertension, diabetes and COPD. He previously worked as a warehouse worker and line technician for the local cable company. Social Security categorized his past work as medium and heavy. They found that he could only do light work. Additionally, Social Security found that here were no transferable skills. Therefore, the Social Security Over 55 Grid Rules directed a finding that he was disabled.
Case study 2: Over 55 Grid Rules
In another example, a 57 year old woman applied for disability benefits due to degenerative joint disease in her right shoulder and right knee. She also suffered from vertigo and major depressive disorder. She previously worked as an accounts receivable clerk. Social Security found that she could do simple, routine and light jobs. Her past work is a sedentary job. However, it requires more complex tasks. Therefore, Social Security found that she could not return to her past job. As a result, her case was approved under the Social Security Over 55 Grid Rules.
Case study 3: Over 55 Grid rules
Lastly, a 59 year old man filed for disability benefits because he had degenerative disc disease in his back, osteoarthritis in his hips and depression. He needed a cane to stand and walk. He previously worked as a truck driver and a waiter. Social Security found that he could do simple, routine sedentary jobs. Since his past work was categorized as light and medium, the Social Security Over 55 Grid Rules applied. Social Security was able to approve his claim.
Working with a SSDI Disability Lawyer
An experienced SSDI disability lawyer will tell if you these grid rules apply in your case. More importantly, a disability lawyer can help you get the evidence you need to apply the Social Security Over 55 Grid Rules and win your case.
Disability Help Group: Winning Social Security Over 55 Grid Rules
For instance, Michael applied for benefits because he had back pain. He was 59 years old and had worked in as a janitor for many years. Unfortunately, Michael was denied for benefits. He had not seen his doctors in a while. However, his doctors had told him that he could not work as a janitor any more. Michael then turned to Disability Help Group. We helped him file an appeal. Our advocate suggested that he see a specialist for his back. Michael started seeing an orthopedist and pain management doctor. We also advised him to have an MRI of his back. At his hearing, the judge found that he could not do his past job as a janitor. The judge found that Michael could not lift or carry 50 pounds. As a result, Michael was limited to light work. The judge approved his case based on the Social Security Over 55 Grid Rules.
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Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.
