In many Social Security disability cases, the decision as to whether the claimant is eligible for benefits comes down to his or her ability to do lighter work than they had done previously. Although a claimant may suffer from legitimate physical and/or mental impairments that limit his day to day activities - perhaps to the extent that the claimant can no longer perform his previous jobs - he will nevertheless be determined ineligible for disability benefits if the SSA or a reviewing court concludes that he can perform other types of jobs. This analysis is based the claimant's residual functional capacity (RFC) - what the claimant can do despite any impairments - in light of the type of jobs available in the national economy for someone with the claimant's age, education and experience.
The RFC determination is crucial to a winning (or losing) case. In Siverio v. Commissioner of Social Security, the Eleventh Circuit Court of Appeal explains that this determination - like the overall disability decision - must be supported by substantial evidence.
The Social Security Administration (SSA) and the ALJ denied Plaintiff Ricardo Siverio's disability benefits claim, finding that although he is unable to return to previous work, Siverio retains the residual functional capacity (RFC) to perform other work that exists in the national economy.
The Eleventh Circuit reversed the ALJ's decision on appeal, taking direct aim at the RFC determination. "RFC is an assessment of a claimant's remaining ability to do work despite his impairments," the court noted, further explaining that "[t]he ALJ must consider any statements by medical sources about what the claimant can still do and whether those statements are based on formal medical examinations."
In this case, the court found that the ALJ's RFC determination was not supported by substantial evidence because it was based on an RFC determination by a "single decision maker": an SSA employee who, according to the court, is "assigned to make the initial disability determination after appropriate consultation with a medical or psychological consultant."
Since a single decision maker does not have medical credentials, the court ruled that such a determination is not an acceptable medical source on which an ALJ may base an RFC determination.
The Court further noted that the remaining evidence in the record was not sufficient to support the ALJ's RFC determination. As a result, it reversed the ALJ's decision and remanded the case for reconsideration of Plaintiff's RFC.
Establishing RFC begins with the proper preparation of a benefits claim, including the medical evidence necessary to show that the claimant is impaired and unable to perform jobs of any kind. In addition to filing the claim, a Social Security disability lawyer can assist a claimant in gathering the required documentation and information and represent the claimant on appeal, if necessary.
While many ALJ's give no weight to the opinion of the Single Decision Maker; anexperienced Disability attorney will know to what judge's this argument must be made expicitly.
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