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RFC assessment and SSDI and SSI

On our previous blog we discussed how the SSA makes their disability determination for SSI or SSDI claimants: a claimant’s condition either meets or exceeds a listing on the SSA Listing of Impairments or they are found disabled through a medical vocational allowance.

Today we are going to discuss the medical vocational allowance process in more detail and discuss how the Disability Determination Services Office medical consultants review your RFC or your residual functional capacity to  determines what level of work you can perform.

What is my residual functional capacity (RFC) work?

The DDS medical consultant has a special process they use to determine whether a claimant has the residual functional capacity (RFC) to perform sedentary, light or medium work. Each type of work has very specific requirements. For instance, a person may be relegated to sedentary work if their medical evidence suggests that they are unable to walk or stand for 5 hours or less per day. If claimants have an unlimited to capacity to walk or stand but cannot lift more than 20 pounds they will be relegated to light work. Claimants who can walk and stand but cannot lift more than 50 pounds for 1/3 of the day will be relegated to medium work.

One of the first tasks for the DDS examiner after they have determined a claimant’s residual functional capacity (RFC) to work and the type of work they can perform is to review the type of work they have done in the past 15 years and whether or not the claimant has the capacity to work a previous job.

For instance, if you are a construction worker who has always done heavy work and you have never had a sedentary job but now, due to your health conditions, you cannot return to heavy work but you are relegated to light or sedentary work, you clearly cannot perform your past work.

Will you be determined disabled? Not yet. First the DDS examiner must determine if you can retrain for new work.

Retraining for new work

If your residual functional capacity only allows you to work a light or sedentary job and you cannot work a past job it is likely that the SSA would assume that you can retrain for sedentary work. For instance, if you had been a nurse but due to a back condition you can no longer lift heavy patients or walk and stand for long periods of time the DDS may decide you can no longer work your past or current job. They must may, however, determine that you could retrain to be a data entry clerk or medical transcriptionist.

It is at this stage in the disability process that age and education play a large role in the DDS examiner’s decision making process. In fact, to standardize the process the SSA has created what they term “grid rules” which are basically a set of grids which outline, based on medical vocational factors, who is and who is not disabled.

Keep in mind, it will be easier for claimants who are older than 55 years of age and who have limited education and no work experience to qualify for benefits. Additionally, those who have less than a 6th grade education and who have been performing unskilled work their entire work lives will also have an easier time proving they cannot retrain for new work.
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