What Is RFC?
If your HIV infection is not severe enough to meet or 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.
Physical and Mental RFC
An RFC for physical impairments is expressed in terms of whether SSA believes you can do heavy, medium, light, or sedentary work in spite of your impairments. The lower your RFC, the less the SSA believes you can do.
An RFC for mental impairments is expressed in terms of whether Social Security Administration believes a claimant can do skilled, semi-skilled, or unskilled work in spite of impairments, or whether the claimant cannot even do unskilled work.
Activities of Daily Living
If your condition is not severe enough to meet or equal a listing, it is very important to provide the Social Security Administration with your symptoms and specific examples about how those symptoms limit your activities of daily living.
Many people with HIV infection have no symptoms before the onset of opportunistic diseases. Some complain of nonspecific symptoms of malaise and fatigue before the onset of any major physical impairment or opportunistic infection. To some extent their activities of daily living may be reduced, but not markedly limited. If you have no symptoms and your immune system is intact, you will not be limited in the work you can do and would not require any RFC. However, if your disease is more advanced and you have medically severe associated symptoms, they could warrant an RFC reduction.
Effect of Medications
The Social Security Administration should take into account that your medications alone can produce extreme fatigue. You may have mental problems either from the effects of HIV directly on the brain, drug side-effects, or impairments arising in association with AIDS. If there is any question about your mental state, family members, friends, or other individuals in contact with you should be asked about symptomatic problems you may be having and how they are functionally limiting.
Ability to Walk, Lift and Carry
If your condition is close to listing-level severity, you should receive no higher than a sedentary RFC. The most significant question is “Can you stand or walk 6 – 8 hours daily?” If not, your RFC will reduce to sedentary work. You should also be asked about your ability to lift and carry. It can be helpful if you can name objects of known weight that you can no longer lift, and activities requiring a particular amount of lifting and carrying that you can no longer do.
The importance of providing the Social Security Administration with your current weight cannot be over-emphasized. Malnutrition and accompanying easy fatigability can significantly limit exertional capacities even without consideration of other limiting factors.
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 HIV Infection Medical Assessment Form.
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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