If you've been diagnosed with a mental illness or disorder that keeps you from working, but you don't meet the criteria for one of Social Security's official disability listings, the agency will look at your “residual functional capacity,” or “RFC,” to determine if you should be granted disability.
Your RFC is sets out what kind of work activities you can do despite your impairment and treatment (such as antidepressant medication). The Social Security Administration (SSA) uses your RFC assessment to determine whether you are capable of performing your prior job or any other kind of work. If the SSA determines that the symptoms associated with your mental disorder and treatment are so limiting that there is no job you can perform, you will be awarded benefits under what is called a “medical-vocational allowance” (as opposed to being allowed under a disability listing).
When you are apply for disability based on a mental disorder, your RFC will focus on your ability to perform mental activities that are needed for work. The SSA will look at different abilities and areas of intellectual and social functioning to determine whether you are "not significantly limited," "moderately limited, "markedly limited," or if there is "insufficient evidence." Unless the SSA finds you markedly limited in one or more areas, you will have a difficult time getting disability benefits. If you are rated as markedly limited, it means you cannot perform even simple, unskilled work.
If you are only moderately limited, the SSA will assess all unskilled jobs to see if you could perform them, not just jobs you have had in the past. Even if you have never performed unskilled work before (for example, if you had a career as a teacher before your impairment), if you are mentally capable of performing unskilled work, the SSA will be able to identify unskilled jobs you could perform.
The SSA will consider four different areas of functioning in determining your mental RFC. Here's how the SSA assesses those areas.
The SSA will look at how well you can understand, carry out, and remember instructions. If you are markedly limited in remembering locations and procedures and in understanding very simple instructions, you cannot perform unskilled work. If you are markedly limited in understanding complicated instructions, it means you cannot perform semiskilled work, but you may be able to perform unskilled work.
Social functioning is also an important aspect of many jobs, and it refers to your ability to interact appropriately with other people for sustained periods of time. If you are markedly limited in your ability to ask simple questions, ask for help, accept feedback appropriately, and interact with coworkers without exhibiting distracting behaviors, you cannot perform unskilled work. You also need to be able to have generally socially acceptable behavior and be able to keep yourself at an acceptable level of cleanliness.
How well you are able to focus on interests and activities is also important in determining your mental RFC. The SSA calls this “concentration, persistence, and pace” and it relates to your ability to pay attention and concentrate long enough to complete common work tasks. If you are found "markedly limited" in any of the following areas related to concentration and persistence, you are unable to perform unskilled work: maintaining concentration and attention; keeping a routine without constant supervision; carrying out simple instructions; preventing being distracted by other people; making simple decisions; staying on schedule; and showing up to work on time.
Your ability to respond and deal with normal work pressures and stresses in a work setting will also be considered. If you are markedly limited in your ability to respond to normal changes in the work environment and to be aware of normal dangers in the work environment, you are unable to perform unskilled work.
Your intellectual functioning is also considered by the SSA in determining your mental RFC. For more information, see our article on Intellectual Functioning and Disability Claims.
You may sometimes see the phrase “decompensation” in SSA reports. Episodes of decompensation are periods of temporary increase in the symptoms of your disorder that require increased medical treatment or a less stressful situation. The SSA will look at how often and how long you have episodes of decompensation.
For more in-depth information, see our section on How Social Security Decides if You Are Disabled.
The SSA will look at both medical and nonmedical evidence in determining your RFC. Your medical record should include all tests (including psychological tests), reports, and observations from medical sources specifically setting forth how often, if at all, you experience things such as: delusions, hallucinations, or paranoid ideas; confusion; phobias or anxiety; and depression or withdrawn behavior. Hopefully your medical record also contains your medical history, any mental status evaluations, and results of psychological tests, diagnoses, treatments prescribed and what your response was, symptoms from treatment, and prognosis. If your application for disability benefits did not include your full medical record, you should contact the SSA immediately and they should be able to tell you how to submit additional evidence.
The SSA will also consider nonmedical evidence, such as reports from people who know you (for example, family, friends, coworkers, supervisors, social workers, and staff in supported living environments) regarding your behavior and how well you can perform activities of daily living. Activities of daily living include things like cleaning, cooking for yourself, shopping, using public transportation, paying bills, and having proper hygiene.
This evidence, both medical and nonmedical, indicates to the SSA what your functional limitations are. For example, if you are extremely withdrawn and anxious around people, you may not be able to have a job that requires close interaction with others. If your disorder requires that you take medications that make you extremely drowsy and slow moving, you may not be able to have a job that requires driving a vehicle or operating dangerous machinery or equipment.
You should also ask your doctor to fill out a mental assessment form detailing your limitations. You can submit it to the SSA and they will use it to create your mental RFC. For a form you can use, see our free mental RFC assessment form.