Residual Functional Capacity and RFC Forms

Welcome to Season 1, Episode 25 of Winning Isn't Easy: Navigating Your Social Security Disability Claim. In this episode, we'll dive into the complicated topic of "Residual Functional Capacity and RFC Forms."

If you think a simple note from your doctor saying you're "disabled" is enough to win your Social Security claim, think again. In this episode of Winning Isn’t Easy, host Nancy L. Cavey pulls back the curtain on one of the most powerful tools in your disability case: the Residual Functional Capacity (RFC) form. Often overlooked, these forms can be the difference between a denial and an approval - if they’re done right. Nancy explains why vague statements don’t move the needle with the Social Security Administration, and how a detailed, condition-specific RFC form can provide the concrete evidence judges need to understand your true limitations. You’ll get practical tips on how to approach your doctor about completing an RFC form, what kinds of details make the biggest impact, and how a skilled disability attorney can help frame your medical story in a way that aligns with the SSA’s expectations. This isn’t just paperwork - it’s your opportunity to be heard clearly and credibly. Whether you're applying for the first time or appealing a denial, this episode is your guide to turning medical facts into persuasive legal evidence. Let’s get started.

In this episode, we'll cover the following topics:

1 -  Why Getting a Letter From Your Doctor That Says You Are Disabled or Meet a Social Security Listing Is a Waste of Time and Money

2 - Should My Social Security Disability Attorney Use a Residual Functional Capacity Form in My Case?

3 - Nine Tips for Getting Winning Social Security Disability Residual Functional Capacity Forms

Whether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.


Listen to Our Sister Podcast:

We have a sister podcast - Winning Isn't Easy: Long-Term Disability ERISA Claims. Give it a listen: https://wiedisabilitypodcast.buzzsprout.com


Resources Mentioned In This Episode:

LINK TO YOUR RIGHTS TO SOCIAL SECURITY DISABILITY: https://mailchi.mp/caveylaw/your-rights-to-social-security-disability-benefits

FREE CONSULT LINK: https://caveylaw.com/contact-us/


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Need help with your Social Security Disability claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.

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Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals.

Transcript

Nancy Cavey [00:00:14]:
 Welcome back to Winning Isn't Easy, the Social Security Disability Benefit version of our podcast. In this podcast, I break down everything you need to know about navigating the Social Security system. I'm your host, Nancy Cavey. Before we get started, I've got to give you a legal disclaimer. This podcast is not legal advice. The Florida Bar association says I've got to tell you this, and now that I've done that, nothing will ever prevent me from giving you an easy to understand overview of the Social Security disability claims process, the games that are played during the whole process from application to hearing, and what you need to know to get the disability benefits you deserve. So off we go now. In the last episode, I talked more about the role of Social Security judges and the decisions that they make that can make or break your disability claim.
 
 Nancy Cavey [00:01:04]:
 Today I want to talk about Residual Functional Capacity Forms, the under the radar document that is the backbone in my view of winning a case. Now, Social Security doesn't care if your doctor writes a letter that says you're disabled. They throw it out because their job is to use the five step sequential evaluation to determine your entitlement to benefits. Condition specific Residual Functional Capacity forms are a more powerful way of your doctor telling the story of your diagnosis, the treatment you've had, and the restrictions and limitations that you have that would prevent you at step four from doing your past work or at step five from doing other work. I'm going to walk through some real life strategies. Talk about how you should talk to your doctor about your limitations and what a Social Security disability attorney can do to help you tell your story in a way that Social Security understands. Now. This just isn't about filling out paperwork.
 
 Nancy Cavey [00:02:04]:
 It's about capturing the full picture of how your condition impacts your life and giving decision makers what they actually need to approve your claim. If you're navigating the Social Security disability application process or your claim has been denied and you're filing a request for reconsideration or have filed a request for a hearing to get your case in front of a judge, you need to listen to this episode because I think it's a game changer. Let's get into it. I'm going to cover three things today. Number one, why getting that letter from your doctor that says you're disabled or that you meet a Social Security listing is a waste of time and money. Number two, should my Social Security disability attorney use Residual Functional capacity forms in my case? And lastly, I've got nine tips for you for getting a winning Social Security Disability Residual Functional Capacity Form. This is going to be an information packed episode. We're going to take a break in a moment, but while you're on break, I want you to come back with a paper and pen so that you can be taking notes.
 
 Nancy Cavey [00:03:08]:
 Got it? Let's take a break.
 
 Speaker B [00:03:11]:
 Are you considering filing for Social Security disability or has your claim been denied already? Either way, you require a copy of your rights to Social Security disability benefits, which will cover everything you need to know about the Social Security disability claims process. Request your free copy of the book@kvlaw.com today.
 
 Nancy Cavey [00:03:35]:
 Welcome back to Winning isn't easy. Getting a letter from your doctor that says you're disabled and are entitled to your Social Security benefits is a waste of time and money. Now as I alluded to before, the Social Security Administration uses a five step sequential evaluation test to determine if you're entitled to to your benefits. And they don't really care if your doctor says you're disabled. It's the Social Security's job to determine if you meet that five step sequential evaluation test because that's the test for being disabled. So getting a letter from your doctor saying you're disabled is a waste of time and money. Now let's talk about steps three, four, and five of the five step sequential evaluation. At step three, the Social Security Administration looks at your medical records to determine if you have a medical condition that is considered severe enough that you would automatically be entitled to your benefits.
 
 Nancy Cavey [00:04:26]:
 The Social Security Administration uses a book called the Listing of Impairments, or the Blue Book. The book is divided into body systems. So remember when we went to high school biology, we learned about the cardiovascular system, the pulmonary system, the digestive system. And this listing of impairments is based on body systems. So we can open up the listing and look for the applicable listing and compare, of course, your medical records to the listing elements. So for example, there's a musculoskeletal listing. So if you've got a problem with your neck, with your, your back, your hips, your knees, even feet, there are listings for those conditions. But every listing has criteria that have to be established based on your medical records that, that establish that you meet or equal the elements of the listing.
 
 Nancy Cavey [00:05:22]:
 Now, I will tell you that more often than not, medical records just don't have the necessary elements of a listing. Why is that? Doctors don't take a class in medical school to learn how to write a report for Social Security purposes. And in fact, most of them hate writing a report or letter. And if you can get them to write a letter. I would rather them have you complete a residual Functional Capacity form because simply saying you meet a listing at step three isn't going to cut it. Now let's talk about the alternative method for establishing that you meet or equal a listing. The first is to actually give the doctor the listing level elements and ask them to write a report outlining the medical evidence that demonstrates that you meet every one of the elements they want, page and verse. I think the better way is to have your doctor complete an applicable Residual Functional Capacity Form.
 
 Nancy Cavey [00:06:21]:
 And these are disease specific and we generally have the elements of the listing in the form. If the RFC form doesn't have the elements of the listing, then we add the applicable elements to the RFC form and ask the doctor to complete it because that RFC form has more than just the information regarding a listing. I'll talk about that in a minute. I think that the Residual Functional Capacity form is important because it addresses things like how long you can stand and walk at one time, how much you can lift, do you need breaks? Would you be off task? How many days a month would you miss? If you have problems with your hands, it's going to address your bilateral manual dexterity. If you have problems with your shoulders, it's going to address your ability to put your arms out in front of you. It's important for you to understand that at step four we have to show that you can't do your past work, but at step five, that you can't do other work in the mythical hypothetical, not real world national economy that you wouldn't want to do and doesn't pay a living wage in view of your age, your education, your skills and your restrictions. And in English, if you're under 50, that generally breaks down to being unable to engage in a sedentary job. And the way that we go about proving that is that Residual Functional Capacity Form.
 
 Nancy Cavey [00:07:43]:
 Now, should you do it by yourself? Well, you're listening to a Social Security disability podcast by a Social Security disability lawyer, so I think you know the answer to that. I think it's really important that you have an experienced Social Security disability attorney who will review your medical records, look to see if they think that you mean a listing, and if not, get out the right residual Functional Capacity form and modify it as needed. Because the whole point here is to establish your entitlement to benefits either at the listing level or that you have sufficient restrictions and limitations that prevent you from doing pass work. Where it's step five, in essence, sedentary work. You don't Want to take a chance with your claim? And you could easily lose valuable Social Security disability benefits and medical coverage by having your doctor write a letter that doesn't count or trying to do it by yourself. Got it. Let's take a break. Welcome back to Winning Isn't Easy.
 
 Nancy Cavey [00:09:16]:
 Should my Social Security disability attorney submit a residual functional capacity to my doctors or give it to me to take to my doctors? Would that help me with my claim? I will tell you absolutely. One of the most powerful tools a Social Security disability attorney can use is a residual functional capacity form. So what is a residual functional capacity form? Well, we Social Security lawyers have developed these forms for the purposes of providing Social Security with information about your diagnosis. Why is that important? Social Security wants to see an objective basis of your diagnosis so they can confirm the that you have what's called a medically determinable impairment at step one. They also want you to your doctor to explain the physical exam findings that are positive and the diagnostic testing that is positive because they want to be able to correlate the physical exam findings and diagnostic testing with the actual diagnosis. And of course, they want to know about your treatment and your response to treatment. They want to understand the course of your diagnosis, your treatment, your progression or your lack of progression, your response to surgeries or injections, so that they literally understand longitudinally the nature of your medical condition. And of course, they also want to understand your restrictions and limitations because they want to understand ultimately and determine from a vocational standpoint at steps four and five, whether you can do your past work or other work in the national economy that requires not only a medical analysis of your restrictions and limitations, but a vocational evaluation or analysis of whether your restrictions preclude you or prevent you from doing the full range of whatever your occupational duties are or other types of occupational duties.
 
 Nancy Cavey [00:11:09]:
 They also want to understand your reaction to medication. Now, I have clients who will tell me that they have medication responses. And. And one of the things that needs to be documented in the medical records is trials at different types of medications and your responses to those medications and potentially your doctor noting that you've had reactions and as a result, there's been a change in the prescriptions. And of course, we want to understand, do you have good days or bad days? How many days would you miss work over the course of a month? Would you have to take breaks? Why? All of those go to the vocational aspects of the case. If you have good days or bad days, you may not be able to show up or miss more than two days of work. Per month. You might have to take frequent breaks that would interfere with your productivity.
 
 Nancy Cavey [00:11:58]:
 All of that's important and is much more detailed than my client can't work. My client's disabled. Now, these RFC forms exist for many medical conditions, and we try to get as many of these completed as are applicable to my client's medical condition and the basis of the claim. So you might have fibromyalgia and a herniated disc in your low back, and you might have some psychological issues. I want at least 3 residual functional capacity forms. So why use a residual functional capacity form? I find that medical records don't tell the full story of your symptoms and restrictions and limitations. If you have a hearing in front of the judge, ultimately the judge is going to have a discussion with a vocational evaluator, an expert in the world of work, and they're going to give that ve a hypothetical based on your restrictions. And so I want the judge to use the residual functional capacity forms to create the hypothetical, or I want to amend it so it fits the facts of the case.
 
 Nancy Cavey [00:13:01]:
 I don't want to leave the hypothetical to chance. So how do I get the RFC forms? Well, guess what? Social Security will never tell you about the forms, and they generally don't tell doctors about the forms. Now, you can go online and Google residual functional capacity form for fibromyalgia, and you'll see examples that we lawyers have created. What I find is that many people pick the wrong form or they try to tailor it to their situation, or they fail to align it to their medical records. These are just some of the reasons why you want an experienced Social Security disability attorney to represent you. Your case is personal to you, and a cookie cutter approach just won't work. So what does a Social Security disability attorney do for you? Well, they're going to develop the medical evidence, get the right RFC form, and implement the best theory and strategy for your case. The goal is to tell the story, your story, in a way that Social Security, the judge, can understand.
 
 Nancy Cavey [00:14:00]:
 And. And that is going to make you the master storyteller. We also want you to be comfortable and confident in front of a judge and explain your symptoms and how those symptoms impact your ability to function. And that would translate into your inability to do your own work or other work. Again, we want to be able to use not only the RFC form, but your testimony about your symptoms and functionality to challenge a hostile vocational evaluator or medical expert and come up with a hypothetical that meets your personal situation. Got it. Let's take a break.
 
 Speaker B [00:14:39]:
 Struggling with your Social Security disability case, the right attorney can make all the difference. Get our booklet the Key to Hiring a Great Attorney for your Social Security Disability Case. Discover how to find an experienced attorney who will fight for your rights and navigate the process with ease. Don't leave your future to chance. Request your free copy@kvlaw.com today and ensure you have the expert support you deserve.
 
 Nancy Cavey [00:15:30]:
 Welcome back to Winning Isn't Easy. All right, you ready? 9 tips for getting Winning Social Security Disability Residual Functional Capacity Forms if you haven't figured out I'm a fan of RFC forms. These disease specific forms can can make a difference in step four and five of the five step Sequential evaluation. That RFC form is going to address things like how long you can sit, stand, walk, how much you can lift, whether you need breaks, your absenteeism, and all sorts of information that's important not only from a medical standpoint, but from a vocational standpoint. Because remember, at step four you have to prove that you can't do your past work, the lightest job you held in the five years before your claim was decided, and at step five that you can't do other work in the mythical, not real world national economy that you wouldn't want to do that does not pay a living wage in view of your age, your education, the skills that you have learned that you might be able to take to other work and your restrictions and limitations. Because the ve ultimately, if we have to go to a hearing, a step five is going to be given a hypothetical by the judge about your capabilities in part based on these Residual Functional capacity forms. So what are the nine tips for getting a winning RFC form? Number one Pick the right form. There are many different forms and you may have more than one medical condition that's the basis of your claim.
 
 Nancy Cavey [00:16:56]:
 So you want to use more than one Residual Functional Capacity form. Now number two, you might want to do a draft RFC form and take it to your doctor. The RFC form will help you tell your story in a way that Social Security understands it. And drafting the form in your own words will help your doctor understand how your symptoms impact or affect you over an eight hour workday. Number three make an appointment with your doctor. You can either make an appointment to fill out the form with your doctor or discuss the form during the regular visit. And if your doctor refuses to complete the form, well, it's time to find a new doctor. Now.
 
 Nancy Cavey [00:17:37]:
 By the way, you don't want the doctor to sign what you've written down because Social Security can understand the differences between handwriting you Want the doctor's staff, and most likely it'll be the staff that'll do it. It'll write in that information and then the doctor will sign it. Number four, schedule an appointment with the right doctor. So having the right specialist complete the RFC form is appropriate. So if you have fibromyalgia, you want to ask your rheumatologist to do it. If they don't, then potentially get your pcp, but preferably have a specialist fill out the form. Number five, tell your doctor what's going on. So at the start of the appointment, explain that you're applying for disability, need their help, Give them relevant test results that they may not have as part of their file and your draft of the RFC form.
 
 Nancy Cavey [00:18:24]:
 Tell them your symptoms and how they impact your ability to do things. It might be that you have difficulty standing in front of the kitchen sink more than 10 minutes and you have to use a stool and sit down. It might be that you spend most of your day in a recliner with your feet elevated. It might be that you have to change positions every 15 minutes. It might be that you have trouble holding on to a coffee cup and your hands go numb and you drop things. So you want to tell the doctor the story of your symptoms and functionality and have that written down so that this can be a very quick, succinct story. Number six, sit with your doctor as they fill out the form. If the doctor is willing, it's better to complete the form together.
 
 Nancy Cavey [00:19:08]:
 And of course, you want to make sure ultimately that that form is completed so that it's consistent with your exam history testing and that is consistent with what you're telling them about your functional restrictions and limitations. Now, sometimes the doctor may ask that you get a functional capacity evaluation. Those are incredibly expensive. They can be 750 to $1,500. I would generally not do that unless you have a short or long term disability claim. That's more, I think, helpful than in a Social Security claim. Number seven, pay the doctor. Well, the doctors are going to charge anywhere from $2,500 to even 1,000 and then they'll charge more if it comes from me because they think I'm the deep pocket, not knowing that you'd reimburse me for that cost.
 
 Nancy Cavey [00:20:07]:
 So I would ask the doctor, do you support my claim? Will you fill out the form and if so, then find out what the cost is. If you can afford it, that's great. If you can't, that's a different issue. And you should be consulting with your lawyer. About that issue. Number eight. Well, what do you do with that completed form? You want to give it to your attorney for review and submission? Sometimes the answers need clarification before it gets electronically filed with the Social Security Administration. There are times when I have to say to my client, doctor needs to go back and clarify this or that.
 
 Nancy Cavey [00:20:43]:
 I know it's a pain, but I would be asking for a specific reason. And number nine, got to make sure that your RFC form is consistent with your medical records. You again should be giving your doctor a history of your symptoms and functionality at each visit, hopefully in a written form that you're keeping. And that needs to be consistent from visit to visit. But it also has to be consistent with the RFC forms and needs to be consistent with any statements that you or loved ones are giving about your pain or your functionality. Got it? Okay, so what should you do next? Well, I think rather than do it alone, you should be hired experienced Social Security disability attorney. The point here is to understand your case. The five step sequential evaluation.
 
 Nancy Cavey [00:21:30]:
 Look at the medical records, look at the work history, think about why it is you couldn't do your past work, choose the right RFC form to document restrictions and limitations, and then of course, strategize and think about how you're going to prove your inability to do any other work in the mythical, not real world national economy if you have your age, education, transferable skills and restrictions. Look, I don't do your job and you really shouldn't be doing the job of a Social Security disability attorney. This is not like a Holiday Inn commercial, if you will. So you owe it to yourself because there's a lot of money and medical benefits at stake to have an experienced Social Security disability attorney look at your case, work with you, use the right residual functional capacity form and be an advocate for you so that you get Social Security disability benefits you deserve. Well, that's it for today's episode of Winning Isn't Easy. I hope that this deep dive into residual functional capacity forms have helped demystify one of the most important pieces of winning a Social Security case. Now, if you've been spinning your wheels with vague doctor notes or generic letters that say you are disabled, know this Social Security isn't interested. They want specifics.
 
 Nancy Cavey [00:22:47]:
 They want structure. They want documentation that clearly spells out how your condition limits your ability to function day to day. And the right RFC form completed by the right doctor with the right strategy can be a game changer. Then can take your claim from incomplete and unconvincing to credible, consistent and the basis of an award. So whether you're in the early stages of a claim, preparing for a hearing, the whole gamut. I filed my claim, I got denied. I'm filing a request for reconsideration. I'm filing a request for a hearing.
 
 Nancy Cavey [00:23:18]:
 Don't go it alone. You need assistance now. If you found this episode helpful, please take a moment to like our page, leave a review, and share it with your family and friends and subscribe to this podcast. I'd love to hear from you. At the beginning of each episode description, you'll find a link that you can use to send us your questions or comments, and I may even feature them in a future episode because I like answering questions. Please join us next week for another insightful episode where we're going to discuss the importance of evidence in a Social Security claim. Thanks for listening.