Anyone who has ever worked at Disability Determination Services as an Examiner knows this basic fact: when it comes to physical impairments (verus psychiatric or psychological) a large percentage of denied claimants are given a medium RFC.
What is an RFC? RFC stands for residual functional capactity and it essentially means "what a claimant is still capable of doing (residually) in spite of the limitations imposed by their impairment or impairments".
RFC determinations are made for every disability claim that proceeds through the SSA evaluative system and the process for determining a particular claimant's RFC is simply this:
-
A disability examiner gathers a claimant's medical records.
-
The examiner reads the claimant's medical records and does a writeup. This writeup
is basically the RFC determination made by the disability examiner.
-
The examiner takes the case file and the writeup to their unit physician (aka the medical consultant aka the dds doctor). Usually, this person is located right down the hall from them.
-
The unit physician either agrees or disagrees with the examiners assessment. But, in either case, the dds doctor completes his or her own assessment which becomes the official RFC determination for the case, resulting in an approval or denial of benefits for the claimant.
This is how claims at the initial and reconsideration levels have always been decided and, most likely, this is how the system will continue to operate for many years ahead.
And, on the face of it, this approach to evaluating claims would seem entirely sound and reasonable...if not for the simple fact that the vast majority of evaluations fall into the medium exertion category. In other words, most claimants who get denied are judged to be capable of medium-level work.
What is medium work and what is a medium RFC? A medium RFC basically means this: after a careful review of a disability claimant's medical records, the conclusion is made that the claimant is capable of lifting fifty lbs occasionally and twenty-five lbs frequently.
Now, how heavy that sounds may depend on an individual's point of view. And Perhaps to some, lifting fifty pounds on an occasional basis would not seem overly burdensome.
But consider this: a 25 inch television typically weights less than fifty pounds. Would anyone reasonably expect a person with severe neck or back pain (or carpal tunnel syndrome or emphysema or heart problems, etc, etc) to lift and carry a 25 inch tv several times each day. Probably not. In fact, the idea seems soundly ludicrous.
Why, then, does the social security administration so routinely make such determinations?
The only plausible answer is that DDS physicians have no idea how fifty pounds really feels, and, as a result, have very little understanding (or empathy) as to how medium-level work might affect a person with a severe physical impairment.
Thus, this suggestion: every DDS medical consultant should be required to keep a 50 lb dumbell beside their desk. And each time a consultant reviews a claimant's medical records and decides to write up a medium RFC, they should be requirely to pick up this weight.
What would a DDS doctor "feel" upon picking up such a heavy weight? Stress in the finger joints and wrist for one thing. However, for a claimant with carpal tunnel syndrome and poor grip strength, this may only serve to further weaken their handling ability.
The DDS doctor would also find that the lifting of a fifty pound weight would introduce significant stress to the back muscles and probably require the use of the lumbar spine area (L5-S1) as a fulcrum. This is something that a person with lumbar degenerative disc disease would be cautioned not to do, at the risk of worsening their back condition.
The DDS physician would also find that lifting this weight would make a significant demand on the neck and shoulder muscles. However, for a claimant with cervical degenerative disc problems, or bone spurs in their neck, this would probably lead to pain, muscle strain, and a worsening of their neck condition.
Giving every doctor who works as a DDS unit physician a 50 lb dumbell and requiring them to lift it at least once each and every day might add a bit more reality to the RFC forms these doctors dole out daily.
And since every human being is, inevitably, subject to some form of musculoskeletal complaint, for the doctor who lifts his weight on the day he has thrown out his back, it might also introduce a level of empathy for the claimant...whose condition is not temporary but long-lasting and perhaps even permanent.
Disability Advocates
Help with Claims
Free Case Evaluation
|
