Social Security Disability Claims and Residual Functional Capacity Assessment

When you first apply for Social Security Disability Insurance Benefits the Social Security Administration (SSA) will ask you for info on where you have been treating. They will ask for all of your medications and also for you and others to fill out a form regarding your activities of daily living. Then the SSA will request all of the relevant records from the hospitals, and clinics where you have treated. They will take all of this information and send it to one of their doctors who may or may not make an appointment to examine you for themselves. Then they will issue a report.

Treating PhysicianThere may even be another that will fill out a form called a Residual Functional Capacity Assessment (RFC). They make them for Physical claims as well as Mental claims. The Administrative Law Judge (ALJ) in your case, if it reaches that level, will put great weight on what these non-treating physicians say. Your greatest weapon against your claim being decided based on opinions of doctors that don’t know you is to provide reports of those that do.

I ask every client of mine to take with them to their next visit with their treating physician my own version of the Residual Functional Capacity Assessment. Because of one judge in particular in my area, my form does not stray too far from the form SSA uses even though I see a lot of flaws in theirs. However, I have noticed that often the treating physician’s opinion paints a much more accurate picture of a person’s ability than the opinion of a non-treating physician and an ALJ is constrained to give the treating physician’s opinion greater weight as long as it is consistent with the rest of the record.

In other words if the SSA doctor says you can lift 50 lbs but your treating physician says you can lift less than 10, usually, the treating physician’s assessment will win out. I say usually because, even though the rules tell the judge to grant it greater weight, they can still make the determination that a treating physician’s opinion on an RFC assessment is inconsistent with the rest of their record and could not be accurate given the weight of the other evidence. However, it is a rare occasion when a treating physician gives you an RFC assessment that is inconsistent with their other treatment records. The point is, do not let the SSA’s doctors do all of the talking in your case. Let the doctors that know you best weigh in.

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