Determining “Residual Functional Capacity”

 Posted on May 16,2020 in Social Security Disability Medical Conditions

In determining eligibility for disability insurance benefits, Social Security must first determine your “residual functional capacity” or RFC. This is an assessment of your ability to work, taking into account any documented physical or mental impairments that you have. By law, Social Security must take all of your limitations into account when formulating an RFC.

Magistrate: Social Security Acknowledged Disability Applicant's Severe Headaches, Yet Did Not Account for Them in RFC

That does not, however, mean that Social Security officials always follow the law. A recent decision from a federal magistrate judge here in Illinois, Charlene J. v. Saul, provides a case in point. This case actually involves a plaintiff who filed for Supplemental Security Income (SSI) benefits. SSI is a type of benefit available to low-income individuals who do not enough of a work history to qualify for disability insurance (SSDI). That said, Social Security uses the same RFC standards when assessing SSI and SSDI claims, so the issues discussed here also apply to disability cases.

Here, a Social Security administrative law judge (ALJ) determined the plaintiff suffered from a number of impairments, including the loss of vision in one eye, type-2 diabetes, and chronic headaches. The ALJ then found that despite these conditions, the plaintiff had the RFC to perform a “full range of medium work” with certain limits. Based on this RFC, the ALJ said the plaintiff could still perform her prior job as a cashier and denied her application for benefits.

On appeal, the magistrate identified a critical flaw in the RFC assessment–the ALJ did not properly account for the impact of the plaintiff's headaches. Indeed, the magistrate said the ALJ failed to “properly explain why his finding … that the Plaintiff had severe headaches did not warrant any functional limitations in the RFC.” (Italics in original)

The plaintiff testified that she suffered, on average, three headaches per week. The ALJ did not believe this, pointing to the fact the plaintiff did not report experiencing a headache during a particular doctor's appointment. The magistrate said such “analysis” was wholly inadequate–and more to the point, inconsistent with the plaintiff's entire medical record. In fact, the plaintiff's doctors had prescribed her medication for headaches several times over the years. And given the ALJ himself concluded the headaches were a “severe impairment,” he still had to account for them somehow in his RFC. For that reason alone, the magistrate said the plaintiff was entitled to a new hearing.

Speak with a Chicago Social Security Disability Attorney Today

Social Security disability claims often succeed or fail based on the RFC assessment. That is why it is so critical to get it right. And when an ALJ makes an incomplete or incorrect RFC determination, you have the right to appeal. A qualified Chicago disability benefits lawyer can represent you throughout this process. So if you need assistance, contact Pearson Disability Law, LLC, at 312-999-0999 today to schedule a free consultation.

Source:

https://www.disabilitylawyerschicago.com/social-security-attorneys/third-disability-hearing-ordered-for-ex-nurse-injured-in-patient-assault