How to Increase Your Odds of Winning a Social Security Disability Case

The Single Best Way to Strengthen Your Disability Case

The best way to make your Social Security Disability case stronger is to get a statement from your doctor about what your limitations are, written in the language the SSA actually uses.

There are a lot of forms floating around, but the two main ones are:

• Physical Residual Functional Capacity (RFC) form
• Mental Residual Functional Capacity Assessment form (SSA uses Form SSA-4734-F4-SUP internally)

You give one or both of these to your doctor, you ask them to fill it out on your behalf, and you say, "I'm applying for disability, it would mean a lot to me if you could complete this form."

If your doctor fills it out in a favorable way, this is the strongest evidence you can have in your Social Security Disability file. Medical records alone don't put the rubber to the road. They show diagnoses, but they rarely spell out whether you can actually work an eight-hour day with your condition. That is exactly what an RFC form does.

For a deeper look at how to approach your doctor about completing these forms, read my Medical Source Statement Walkthrough.

Walking Through the Mental RFC Form

Let me walk through the key sections of the mental RFC form so you know what to expect.

Provider and Patient Information

The top of the form covers the basics: provider's name, telephone, patient information, date impairment began, and diagnosis.

Critical Yes/No Questions

These early questions set the tone for the entire form. Get them wrong and the rest barely matters.

• "Do you believe the patient is a malingerer?" The answer needs to be NO.
• "Has the patient's impairment lasted or is expected to last at least 12 months?" The answer needs to be YES.
• "Is the patient compliant with treatment?" The answer should be YES.

GAF Score (Global Assessment of Functioning)

The form may ask about your GAF score. The GAF was dropped from the DSM-5 in 2013 and replaced by the WHODAS 2.0. SSA disability adjudicators do not rely heavily on GAF scores in their decisions, though the agency has acknowledged that a GAF from an acceptable medical source can still be considered as a medical opinion. Bottom line: this is not the most important part of the form.

Drug and Alcohol Use

• "Is there evidence of current drug or alcohol use?" Hopefully the answer is NO.
• "If so, would the impairment exist in the absence of drug or alcohol use?" If drug or alcohol use is in your background, this answer needs to be YES. If SSA believes substance use is the reason you cannot work, rather than your medical conditions, they will deny you. If they see active use in your records at all, they will usually deny you unless your conditions are truly catastrophic.

The Meat and Potatoes: Functional Limitation Ratings

This is where the form gets important. For each work-related mental activity, your doctor rates your limitation as:

• None
• Mild
• Moderate
• Marked
• Extreme

I tell every single one of my clients: judges generally do not pay attention to "none," "mild," or "moderate." What moves the needle is Marked and Extreme, which mean "seriously limited" or "no ability to function" in that area.

Understanding and Memory

• Ability to remember locations and work-like procedures: Marked or Extreme is what you are looking for.
• Ability to remember very short and simple instructions: Marked or Extreme, if the judge believes the rating, will lead to a finding of disability.
• Ability to understand and remember detailed instructions: This one is especially important if you are over 50 and trying to show you cannot do your past work. If your past work required detailed instructions and you can no longer handle that level of complexity, it can be used to rule out your past relevant work under the SSA's grid rules.

Sustained Concentration and Persistence

• Ability to carry out very short and simple instructions: Marked or Extreme will get it done.
• Ability to carry out detailed instructions: Another question that matters for eliminating jobs, especially if you are over 50.
• Ability to maintain attention and concentration for extended periods: Very important. Marked or Extreme is what you want.
• Ability to perform activities on schedule, maintain regular attendance, and be punctual within customary tolerances: Marked or Extreme here is strong evidence.

I do not want to turn this into a 40-minute walkthrough telling you that you want Marked and Extreme on every single line, but you do. Realistically, most doctors will not mark every line as Marked or Extreme, and that is fine. You are looking for Marked or Extreme ratings in the areas that would prevent you from performing any work, not just skilled work.

Other Key Mental Limitations

• Ability to tolerate normal levels of stress: Very important. If you cannot handle normal workplace stress, you are looking for a Marked or Extreme limitation here.
• Ability to set realistic goals or make plans independently: Less important.
• Ability to travel to unfamiliar places: Less important.

Absences and Interference with Work

• "Would your patient's impairment substantially interfere with his or her ability to work on a regular and sustained basis at least 20% of the time?" You want a YES.
• "How often would your patient need to miss work each month?" Sometimes one day a month will be enough depending on the judge. Two days a month, if the judge agrees with your doctor's assessment, should always be enough. I have never seen it not be enough to get disability.

Narrative Section and Fund Management

Your doctor can do you a real solid by writing a few sentences explaining why they completed the form the way they did. A brief narrative goes a long way.

The form also asks whether the patient can manage his or her own funds. If your doctor says no, SSA will likely assign a representative payee to manage your benefits for you.

Walking Through the Physical RFC Form

The physical RFC form is structured differently from the mental form, but the stakes are the same.

Contact and Symptom Information

• Frequency and purpose of contact with the patient: Not critical. The judge will know this from your medical records.
• Patient's symptoms: Hopefully your doctor provides a thorough description of your pain and physical limitations.
• Clinical findings and diagnosis: Again, this will largely be in your medical records already.

Exertional Limitations: Where It Really Matters

This is the section that wins or loses physical disability cases.

Lifting and Carrying

• Occasionally lift and/or carry (including upward pulling): For most people, you want this to be less than 10 pounds. Under SSA rules, sedentary work involves lifting no more than 10 pounds at a time. If you are over 50 and your doctor says you can only lift 20 pounds, that alone may help you win under the grid rules. If you are over 55, that restriction is even more powerful.
• Frequently lift and/or carry: The lower the better for your case, though this is not the biggest factor on the form.

Standing and Walking

If you are over 50, this is the big one. Under SSA Ruling SSR 83-10, sedentary work requires standing or walking for no more than about 2 hours in an 8-hour workday. If your doctor says you can stand and walk for less than 2 hours and you cannot do your past work, that is a strong path to a favorable decision, assuming the judge adopts the doctor's opinion.

The grid rules at 20 CFR Part 404, Subpart P, Appendix 2 recognize that individuals age 50 to 54 who are restricted to sedentary work and have no transferable skills are generally found disabled. At age 55 and older, the rules become even more favorable.

Sitting

If you are under 50, this is the one to focus on. Under SSR 96-9p, performing the full range of sedentary work requires sitting for approximately 6 hours in an 8-hour workday. If your doctor says you cannot sit for 6 hours, that is potentially disabling because it means you cannot even do desk work.

Postural and Manipulative Limitations

• Push and/or pull: Not as critical in most cases.
• Postural limitations (stooping, crouching, climbing): These mainly benefit people over 50 in showing they cannot do their past work.
• Manipulative limitations (handling, fingering, reaching): Super important. Nearly every job requires you to use your hands. If your doctor marks that you can never or only occasionally handle or finger, combined with other impairments, that can be disabling on its own.

Absences and Off-Task Time

• How frequently would you expect the patient to experience absences from work? Once a month can sometimes be enough. Twice a month or more will generally always win, so long as the judge adopts your doctor's opinion.
• What percentage of the workday would the patient be off task? 5% will not get it done. 10% will sometimes be enough. 15% to 20% will generally always be disabling if the judge adopts the opinion.

Malingering

The form asks whether the patient is a malingerer, which is a fancy word for "faker." You want your doctor to put NO.

Get These Forms and Use Them

If you are applying for disability, you need to get your doctors to complete these forms. The answers on these forms can be the difference between winning and losing.

If you want a copy of both forms, download my free guide to Social Security Disability (click on "Get Your Free Guide" above). The physical and mental RFC forms are attached to the back of that guide. Use them for your case.

If you are getting ready for a hearing, you may also want to read my 5 Tips to Prepare for Your Disability Hearing and make sure your disability paperwork does not accidentally hurt your case.

I hope you win.