Social Security Disability and Functional Limitations
Many individuals who file for disability do so with the idea that they should qualify for disability because they are no longer able to perform the requirements of their last job. And to some extent, this assumption is correct. The inability to engage in one's past work is one requirement that must be fulfilled in order to receive disability benefits from the social security administration.
However, the social security definition of disability is a bit more detailed than that.
For one thing, when it comes to an applicant's past work, social security not only considers the most recent job that an applicant performed, but sometimes many, and sometimes even all, of the jobs the applicant performed within the last fifteen year period (known as the relevant period by social security). This is provided, of course, that the applicant performed the job long enough to become a relevant part of their vocational work profile.
Assuming that SSA makes the determination that an applicant for disability cannot return to their past work (meaning that a disability examiner or a disability judge has determined that the applicant cannot return to any of their jobs performed within the past 15 years), the determination must still be made as to whether or not a claimant can perform some type of other work.
Jobs that fall into the "other work" category include various jobs (none of which a claimant may necessarily have ever done) for which a claimant might be thought capable of transitioning to based on their age, education, level of work skills, and limitations, both physical and mental.
Limitations in functionality are a core consideration for both social security disability and SSI disability claims. This is because by comparing the physical and mental capabilities that a claimant still retains (this is a concept known as residual functional capacity, which simply means the functional capacity that a person still has remaining), the social security administration may do the following:
A) They can measure the individual's level of functionality against the requirements of their past jobs to determine if they can go back to one of those jobs
and
B) They can measure the the claimant's level of remaining function against the requirements of certain "other jobs" to determine if they actually have the capability to transition to one of those jobs.
Limitations in functionality (in other words, limitations in the ability to sit, stand, crouch, stoop, lift, hold, hear, see, smell, speak, remember, learn, get along with others, etc, etc, etc) make all the difference as to whether or not a person will be approved for disability or denied for disability benefits. And evidence of such limitations are exactly what disability examiners (at the initial disability claim and reconsideration appeal levels) are looking for.
Unfortunately, most physicians do not include in their notes very much in the way of statements regarding observed functional limitations. Why don't they?
The answer is probably as simple as this: they record the information they need, versus the kind of information that may be needed by others, potentially, at some point---including insurance companies, attorneys, and the social security administration.
Because doctors typically do not write their progress notes with the goal of indicating a patient's functionality (and if you think about it, this makes sense for them as doctors are doctors and are not therapists), it really becomes part and parcel of the job of a disability adjudicator (an administrative law judge or a disability examiner) to extrapolate a claimant's residual functional capacity from what can be gleaned and inferred from a reading of the medical records.
Of course, this is where the subjective nature of a social security disability or SSI disability claim really comes into play. Because what one disability decision maker may extrapolate (to extrapolate is to draw is to draw a conclusion from a series of known facts) may not necessarily be what another individual might extrapolate based on a reading of the medical records.
For this reason, of course, getting a medical source statement from a claimant's treating physician, either on an RFC (residual functional capacity) form or on a medical source statement (same thing, different name) can be paramount to winning a claim. Such a statement can effectively present a rationale to a decision-maker as to why a claimant should be approved or denied. And it does this by having the physician do, in fact, what none of his actual medical records did; that is, state what the claimant's level of function is. For example, a good RFC form may ask for an extensive amount of information regarding the following (but certainly not limited to the following):
A) Has the impairment (or impairments) lasted, or can be expected to last, 12 months?
B) To what degree is the patient limited in the ability to deal with work stress.
C) How often is the patient's pain severe enough to interfere with attention and concentration?
D) Is the patient a malingerer?
E) Does the patient experience medication side effects that may have implications for working?
F) Does the patient experience pain and, if so, what is the nature, location, frequency, and severity of the pain?
These, of course, are just a few examples of the types of questions that might be asked of one's treating physician on a form of this type. A good form that is designed to obtain a detailed medical source statement from a doctor can easily have 20+ areas for the doctor to address. However, if the form is constructed in a check-off format, the form can still easily be completed by the physician in roughly ten to fifteen minutes, including the time it takes the doctor to pull and quickly review the patient's file.
The medical source statement / residual functional capacity form that is available from this site, www.disabilitysecrets.com may be obtained by visiting the home page, scrolling to the bottom, and clicking the download link for either the mental or physical RFC form.
Return to:
Social Security Disability Secrets
Social Security Disability Benefit Questions
Other Posts
Avoidance of Back Pain
Decision to File for Disability
How to file for disability
File for Disability, applying, appealing
Filing an SSI Disability Claim for a Child
Losing a Disability Case - How to Lose an SSD or SSI Claim
Caffeine May Help MS from Developing
Multiple Sclerosis and Vision
Return to:
Social Security Disability Secrets
Social Security Disability Benefit Questions
However, the social security definition of disability is a bit more detailed than that.
For one thing, when it comes to an applicant's past work, social security not only considers the most recent job that an applicant performed, but sometimes many, and sometimes even all, of the jobs the applicant performed within the last fifteen year period (known as the relevant period by social security). This is provided, of course, that the applicant performed the job long enough to become a relevant part of their vocational work profile.
Assuming that SSA makes the determination that an applicant for disability cannot return to their past work (meaning that a disability examiner or a disability judge has determined that the applicant cannot return to any of their jobs performed within the past 15 years), the determination must still be made as to whether or not a claimant can perform some type of other work.
Jobs that fall into the "other work" category include various jobs (none of which a claimant may necessarily have ever done) for which a claimant might be thought capable of transitioning to based on their age, education, level of work skills, and limitations, both physical and mental.
Limitations in functionality are a core consideration for both social security disability and SSI disability claims. This is because by comparing the physical and mental capabilities that a claimant still retains (this is a concept known as residual functional capacity, which simply means the functional capacity that a person still has remaining), the social security administration may do the following:
A) They can measure the individual's level of functionality against the requirements of their past jobs to determine if they can go back to one of those jobs
and
B) They can measure the the claimant's level of remaining function against the requirements of certain "other jobs" to determine if they actually have the capability to transition to one of those jobs.
Limitations in functionality (in other words, limitations in the ability to sit, stand, crouch, stoop, lift, hold, hear, see, smell, speak, remember, learn, get along with others, etc, etc, etc) make all the difference as to whether or not a person will be approved for disability or denied for disability benefits. And evidence of such limitations are exactly what disability examiners (at the initial disability claim and reconsideration appeal levels) are looking for.
Unfortunately, most physicians do not include in their notes very much in the way of statements regarding observed functional limitations. Why don't they?
The answer is probably as simple as this: they record the information they need, versus the kind of information that may be needed by others, potentially, at some point---including insurance companies, attorneys, and the social security administration.
Because doctors typically do not write their progress notes with the goal of indicating a patient's functionality (and if you think about it, this makes sense for them as doctors are doctors and are not therapists), it really becomes part and parcel of the job of a disability adjudicator (an administrative law judge or a disability examiner) to extrapolate a claimant's residual functional capacity from what can be gleaned and inferred from a reading of the medical records.
Of course, this is where the subjective nature of a social security disability or SSI disability claim really comes into play. Because what one disability decision maker may extrapolate (to extrapolate is to draw is to draw a conclusion from a series of known facts) may not necessarily be what another individual might extrapolate based on a reading of the medical records.
For this reason, of course, getting a medical source statement from a claimant's treating physician, either on an RFC (residual functional capacity) form or on a medical source statement (same thing, different name) can be paramount to winning a claim. Such a statement can effectively present a rationale to a decision-maker as to why a claimant should be approved or denied. And it does this by having the physician do, in fact, what none of his actual medical records did; that is, state what the claimant's level of function is. For example, a good RFC form may ask for an extensive amount of information regarding the following (but certainly not limited to the following):
A) Has the impairment (or impairments) lasted, or can be expected to last, 12 months?
B) To what degree is the patient limited in the ability to deal with work stress.
C) How often is the patient's pain severe enough to interfere with attention and concentration?
D) Is the patient a malingerer?
E) Does the patient experience medication side effects that may have implications for working?
F) Does the patient experience pain and, if so, what is the nature, location, frequency, and severity of the pain?
These, of course, are just a few examples of the types of questions that might be asked of one's treating physician on a form of this type. A good form that is designed to obtain a detailed medical source statement from a doctor can easily have 20+ areas for the doctor to address. However, if the form is constructed in a check-off format, the form can still easily be completed by the physician in roughly ten to fifteen minutes, including the time it takes the doctor to pull and quickly review the patient's file.
The medical source statement / residual functional capacity form that is available from this site, www.disabilitysecrets.com may be obtained by visiting the home page, scrolling to the bottom, and clicking the download link for either the mental or physical RFC form.
Return to:
Other Posts
Avoidance of Back Pain
Decision to File for Disability
How to file for disability
File for Disability, applying, appealing
Filing an SSI Disability Claim for a Child
Losing a Disability Case - How to Lose an SSD or SSI Claim
Caffeine May Help MS from Developing
Multiple Sclerosis and Vision
Labels: social security disability functional limitations
Return to: