What Is RFC?
If your fibromyalgia is not severe enough to equal a listing at Step 3 of the Sequential Evaluation Process, the Social Security Administration will need to determine your residual functional capacity (RFC) to decide whether you are disabled at Step 4 and Step 5 of the Sequential Evaluation Process.
RFC is a claimant’s ability to perform work-related activities. In other words, it is what you can still do despite your limitations. An RFC for physical impairments is expressed in terms of whether the Social Security Administration believes you can do heavy, medium, light, or sedentary work in spite of your impairments. An RFC for mental impairments is expressed in terms of whether Social Security Administration believes the claimant can do skilled, semi-skilled, or unskilled work in spite of impairments, or whether the claimant cannot even do unskilled work. The lower your RFC, the less the Social Security Administration believes you can do.
RFC and Fibromyalgia
If you have fibromyalgia, you may have significant residual limitations that could potentially result in allowance of your claim.
In determining your RFC, the Social Security Administration adjudicator should consider all of your symptoms in deciding how they may affect your ability to function. Symptoms of fibromyalgia that the adjudicator should consider include those mentioned in the American College of Rheumatology’s definition of fibromyalgia:
Other typical symptoms that could limit you functional capacity include:
The Social Security Administration has issued a ruling that provides guidance to Social Security Administration adjudicators about what to consider in assessing a fibromyalgia claimant’s RFC. In evaluating the credibility of the symptoms you report, the adjudicator should ask your treating doctor or other medical sources to provide information about the extent and duration of your impairments, including observations and opinions about how well you are able to function, the effects of any treatment, including side effects, and how long the impairments are expected to limit your ability to function.
Opinions from your medical sources, especially treating doctors, concerning the effects of fibromyalgia on your ability to function in a sustained manner in performing work activities or in performing activities of daily living are important in enabling adjudicators to draw conclusions about the severity of your impairments. Any information a medical source is able to provide contrasting your impairments and functional capacities since the onset of your fibromyalgia with your status before its onset will be helpful in evaluating your impairments and their functional consequences. See Getting Your Doctor’s Opinion About What You Can Still Do.
Information from third-parties may be very useful in deciding your credibility. Information other than your allegations and reports from your treating doctors helps the adjudicators to assess your ability to function on a day-to-day basis and to depict your capacities over a period of time. Such evidence includes, but is not limited to:
Your Doctor’s Medical Opinion Can Help You Qualify for Social Security Disability Benefits
The Social Security Administration’s job is to determine if you are disabled, a legal conclusion based on your age, education and work experience and medical evidence. Your doctor’s role is to provide the Social Security Administration with information concerning the degree of your medical impairment. Your doctor’s description of your capacity for work is called a medical source statement and the Social Security Administration’s conclusion about your work capacity is called a residual functional capacity assessment. Residual functional capacity is what you can still do despite your limitations. The Social Security Administration asks that medical source statements include a statement about what you can still do despite your impairments.
The Social Security Administration must consider your treating doctor’s opinion and, under appropriate circumstances, give it controlling weight.
The Social Security Administration evaluates the weight to be given your doctor’s opinion by considering:
When to Ask Your Doctor for an Opinion
If your application for Social Security disability benefits has been denied and you have appealed, you should get a medical source statement (your doctor’s opinion about what you can still do) from your doctor to use as evidence at the hearing.
When is the best time to request an opinion from your doctor? Many disability attorneys wait until they have reviewed the file and the hearing is scheduled before requesting an opinion from the treating doctor. This has two advantages.
But this approach also has some disadvantages.
Here is an alternative. Suggest that your attorney request your doctor to complete a medical opinion form on the day you retain your attorney. This will provide a snapshot description of your residual functional capacity (RFC) early in the case. If you improve and return to work, the description of your RFC provides a basis for showing that you were disabled for a specific period. If you change doctors, your attorney can get an opinion from the new doctor, too. If you stop seeing doctors, at least your attorney has one treating doctor opinion and can present your testimony at the hearing to establish that you have not improved.
If you continue seeing the doctor but it has been a long time since the doctor’s opinion was obtained, just before the hearing your attorney can send the doctor a copy of the form completed earlier, along with a blank form and a cover letter asking the doctor to complete a new form if your condition has changed significantly. If not, your attorney can ask the doctor to send a one-line letter that says there have been no significant changes since the date the earlier form was completed.
There are times, though, that your attorney needs to consider not requesting a report early in the case.
Medical Opinion Forms
Medical opinion forms can be great time savers for both your attorney and your doctor, but they must be used with care. Forms may not be appropriate at all in complex cases; and they need to be supplemented in many cases so that all issues are addressed. The best forms are clear and complete but not too long.
When the time is right, here is a form for your disability attorney to use:
Continue to the full version of the Fibromyalgia Medical Source Statement.
Go back to About Fibromyalgia and Disability.
We handle California Social Security disability claims for claimants from San Diego and nearby areas, including these counties and cities:
Imperial, Orange, Riverside, and San Diego.
Imperial County: Brawley, Calexico, and El Centro.
Orange County: Anaheim, Buena Park, Costa Mesa, Fountain Valley, Fullerton, Garden Grove, Huntington Beach, Irvine, La Habra, Laguna Niguel, Lake Forest, Mission Viejo, Newport Beach, Orange, Santa Ana, Tustin, Westminster, and Yorba Linda.
Riverside County: Corona, Hemet, Moreno Valley, Palm Desert, Palm Springs, Riverside, and Temecula.
San Diego County: Carlsbad, Chula Vista, El Cajon, Encinitas, Escondido, La Mesa, National City, Oceanside, Poway, Ramona, San Diego, San Marcos, Santee, and Vista.
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