· web viewin the preceding chart, lifting, pushing, and pulling are expressed in terms of both...

Colleagues,

Constructing function by function Residual Functional Capacity statements, consistent with the evidence before us, is among our most important tasks as Administrative Law Judges. If we learn and use defined terms to describe impairment caused, work- related functions and translate the terms we find in medical source statements into the appropriate term for the evidence in the case before us, we will see fewer remands.

Therefore, we recommend you study and employ these terms as defined in Appendix C of Selected Characteristics of occupations, which is part of the Dictionary of Occupational Titles. We can take judicial notice of these documents according to 20 CFR 404.1566(d)(1) and 416.966(d)(1).

The Keys that follow are based on reliable Agency continuing education materials including samples from our Office of Appellate Operations, ODAR Continuing Education Program, ALJ Initial Orientation Modules, and Judicial Conferences.

Our Case Studies are designed to start discussion of what makes up a legally sufficient and effective RFC.

The RFC Checklist is a tool from our electronic Bench Book, and is used now for both Initial and Supplemental ALJ Training.

Thanks for organizational support to our Office of the Chief Administrative Law Judge, Judges David Stephens and John Costello, and to the Association of Administrative Law Judges for this forum. We hope you enjoy the program!

-Mike Brownfield and Cam Oetter

APPENDIX C

Physical Demands Physical Demand components, as used within the U.S. Employment Service (USES) Occupational Analysis Program, provide a systematic way of describing the physical activities that an occupation requires of a worker.

Within USES, the assessment of physical demands

is focused primarily on the physical demands of the job— not the physical capacities of the worker; provides the means to combine information about many jobs into composite occupational

information; permits the matching of workers and jobs based upon the workers' capabilities; permits the modification of the physical demands of a job to fit the capabilities of disabled workers.

PHYSICAL DEMAND FACTORS AND DEFINITIONS

The Physical Demands of an occupation are described in relationship to twenty different factors.

1. STRENGTH

This factor is defined by one of five levels: Sedentary, Light, Medium, Heavy, and Very Heavy. Most jobs require workers to expend energy to some extent. The amount can be affected by a worker's body position and the frequency of the repetition of a task. For instance, a worker in an awkward crouching position may experience as much difficulty exerting five pounds of force as when exerting thirty pounds at waist height while standing. Further, a worker who continuously lifts, pushes, or pulls 15-pound objects or carries them over long distances may exert as much physical effort as when lifting, pushing, pulling, or carrying 30-pound objects over short distances on a frequent basis.

To determine Strength Level, analysts review three elements in the physical demands of a job and condense these three elements into a single rating reported as the overall Strength Level of the occupation. The three elements and their subcomponents are defined below:

a. Body Position

Standing: Remaining on one's feet in an upright position at a work station without moving about.

Walking: Moving about on foot.

Sitting: Remaining in a seated position.

b. Weight/Force

Lifting: Raising or lowering an object from one level to another (includes upward pulling).

Carrying: Transporting an object, usually holding it in the hands or arms or on the shoulder.

Pushing: Exerting force upon an object so that the object moves away from the force (includes slapping, striking, kicking, and treadle actions).

Pulling: Exerting force upon an object so that the object moves toward the force (includes jerking).

c. Controls: Hand-Arm and Foot-Leg

Controls entail use of one or both arms or hands (hand-arm) or one or both feet or legs (foot-leg) to move controls on machinery or equipment. Controls include, but are not limited to, buttons, knobs, pedals, levers, and cranks.

Physical Demand factors other than those listed above may affect the Strength Level rating. Analysts consider these factors when they are present and adjust the overall Strength Level rating accordingly.

Sedentary Work

Sedentary Work involves exerting up to 10 pounds of force occasionally or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs may be defined as Sedentary when walking and standing are required only occasionally and all other Sedentary criteria are met. In Part A of this publication, occupations rated Sedentary have an S in the Strength column.

Light Work

Light Work involves exerting up to 20 pounds of force occasionally, or up to 10 pounds of force frequently, or a negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job/occupation is rated Light Work when it requires: (1) walking or standing to a significant degree; (2) sitting most of the time while pushing or pulling arm or leg controls; or (3) working at a production rate pace while constantly pushing or pulling materials even though the weight of the materials is negligible. (The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible.) In Part A of this publication, occupations rated Light have an L in the Strength column.

Medium Work

Medium Work involves exerting 20 to 50 pounds of force occasionally, or 10 to 25 pounds of force frequently, or an amount greater than negligible and up to 10 pounds constantly to move objects. Physical demand requirements are in excess of those for Light Work, In Part A of this publication, occupations rated Medium have an M in the Strength column.

Heavy Work

Heavy Work involves exerting 50 to 100 pounds of force occasionally, or 25 to 50 pounds of force frequently, or 10 to 20 pounds of force constantly to move objects. Physical demand requirements are in excess of those for Medium Work. In Part A of this publication, occupations rated Heavy have an H in the Strength column.

Very Heavy Work

Very Heavy Work involves exerting in excess of 100 pounds of force occasionally, or in excess of 50 pounds of force frequently, or in excess of 20 pounds of force constantly to move objects. Physical demand requirements are in excess of those for Heavy Work. In Part A of this publication, occupations rated Very Heavy have a V in the Strength column.

LIMITS OF WEIGHTS LIFTED/CARRIED OR FORCE EXERTED

Rating Occasionally

Frequently Constantly

Sedentary *— 10 * N/ALight *— 20 *— 10 *Medium 20—50 10—25 *— 10Heavy 50—100 25—50 10—20Very Heavy 100 + 50 + 20 +* = negligible weight; N/A = Not Applicable

In the preceding chart, lifting, pushing, and pulling are expressed in terms of both intensity and duration. Judgments regarding intensity involve consideration of the weight handled, position of the worker's body or the part of the worker's body used in handling weights, and the aid given by helpers or by mechanical equipment. Duration is the total time spent by the worker in carrying out these activities. Carrying most often is expressed in terms of duration, weight carried, and distance carried. This information is summarized in the table on the next page.

The range excludes the lower number and includes the higher number, i.e., the range 10—25 excludes 10 (begins at 10 +) and includes 25. Overlapping ranges of *—10 in the Occasionally column for Sedentary Work and Light Work occupations are differentiated on the basis of the worker's posture and the rate at which work is performed. For example, all Sedentary occupations involve sitting constantly. However, in some occupations workers sit constantly but exert force of an amount or at a frequency rate that exceeds those for Sedentary Work. Such occupations are, therefore, rated at least for Light Work.

ABSENCE OR PRESENCE OF OTHER PHYSICAL DEMAND COMPONENTS

Analysts use the following symbols to indicate the absence or presence (and when present, the frequency of occurrence) of the other nineteen Physical Demand components.

Code

Frequency Definition

N Not Present Activity or condition does not exist.O Occasionally Activity or condition exists up to 1/3 of the time.

F Frequently Activity or condition exists from 1/3 to 2/3 of the time.C Constantly Activity or condition exists 2/3 or more of the time.

2. CLIMBING

Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like, using feet and legs or hands and arms. Body agility is emphasized. In Part A, the rating for the Climbing component appears second in the first Physical Demand column under the vertical heading Cl.

3. BALANCING

Maintaining body equilibrium to prevent falling when walking, standing, crouching, or running on narrow, slippery, or erratically moving surfaces; or maintaining body equilibrium when performing gymnastic feats. In Part A, the rating for the Balancing component appears third in the first Physical Demand column under the vertical heading Ba.

4. STOOPING

Bending body downward and forward by bending spine at the waist, requiring full use-of the lower extremities and back muscles. In Part A, the rating for the Stooping component appears fourth in the first Physical Demand column under the vertical heading St.

5. KNEELING

Bending legs at knees to come to rest on knee or knees. In Part A, the rating for the Kneeling component appears fifth in the first Physical Demand column under the vertical heading Kn.

6. CROUCHING

Bending body downward and forward by bending legs and spine. In Part A, the rating for the Crouching component appears sixth in the first Physical Demand column under the vertical heading Co.

7. CRAWLING

Moving about on hands and knees or hands and feet. In Part A, the rating for the Crawling component appears seventh in the first Physical Demand column under the vertical heading Cw.

8. REACHING

Extending hand(s) and arm(s) in any direction. In Part A, the rating for the Reaching component appears eighth in the first Physical Demand column under the vertical heading Re.

9. HANDLING

Seizing, holding, grasping, turning, or otherwise working with hand or hands. Fingers are involved only to the extent that they are an extension of the hand, such as to turn a switch or shift automobile gears. In Part A, the rating for the Handling component appears ninth in the first Physical Demand column under the vertical heading Ha.

10. FINGERING

Picking, pinching, or otherwise working primarily with fingers rather than with the whole hand or arm as in handling. In Part A, the rating for the Fingering component appears tenth (last) in the first Physical Demand column under the vertical heading Fi.

11. FEELING

Perceiving attributes of objects, such as size, shape, temperature, or texture, by touching with skin, particularly that of fingertips. In Part A, the rating for the Feeling component appears first in the second set of Physical Demand ratings under the vertical heading Fe.

12. TALKING

Expressing or exchanging ideas by means of the spoken word to impart oral information to clients or to the public and to convey detailed spoken instructions to other workers accurately, loudly, or quickly. In Part A, the rating for the Talking component appears second in the second set of Physical Demand ratings under the vertical heading Ta.

13. HEARING

Perceiving the nature of sounds by ear. In Part A, the rating for the Hearing component appears third in the second set of Physical Demand ratings under the vertical heading He.

14. TASTING/SMELLING

Distinguishing, with a degree of accuracy, differences or similarities in intensity or quality of flavors or odors, or recognizing particular flavors or odors, using tongue or nose. In Part A, the rating for the Tasting/Smelling component appears fourth in the second set of Physical Demand ratings under the vertical heading TS.

15. NEAR ACUITY

Clarity of vision at 20 inches or less. In Part A, the rating for the Near Acuity component appears fifth in the second set of Physical Demand ratings under the vertical heading NA. 16. FAR ACUITY

Clarity of vision at 20 feet or more. (Note: There is no Physical Demand component for rating clarity of vision in the middle distance of 20 inches to 20 feet.) In Part A, the rating for the Far Acuity component appears sixth in the second set of Physical Demand ratings under the vertical heading FA.

17. DEPTH PERCEPTION

Three-dimensional vision. Ability to judge distances and spatial relationships so as to see objects where and as they actually are. In Part A, the rating for the Depth Perception component appears seventh in the second set of Physical Demand ratings under the vertical heading DP.

18. ACCOMMODATION

Adjustment of lens of eye to bring an object into sharp focus. This factor is required when doing near point work at varying distances from the eye. In Part A, the rating for the Accommodation component appears eighth in the second set of Physical Demand ratings under the vertical heading Ac.

19. COLOR VISION

Ability to identify and distinguish colors. In Part A, the rating for the Color Vision component appears ninth in the second set of Physical Demand ratings under the vertical heading CV.

20. FIELD OF VISION

Observing an area that can be seen up and down or to right or left while eyes are fixed on a given point. In Part A, the rating for the Field of Vision component appears last in the second set of Physical Demand ratings under the vertical heading FV.

APPENDIX D

Environmental Conditions

Environmental Condition components within the USES Occupational Analysis Program provide a systematic means to describe fourteen possible surroundings or settings in which the occupation is found or the job may be performed.

For thirteen of these factors, analysts determine whether a factor is absent or present. When they determine that a factor is present, they then determine whether it has an effect on the occupation in terms of its frequency of occurrence. (Analysts use the same scale and symbols, reproduced below, to rate both Environmental Conditions and Physical Demands.) For one factor, Noise, analysts estimate the general or typical intensity level of the immediate surroundings in which the occupation occurs. The scale for Noise Intensity Level appears with the definition for Noise.

ABSENCE OR PRESENCE OF ENVIRONMENTAL CONDITION COMPONENTS

Code

Frequency Definition

N Not Present Activity or condition does not exist.O Occasionally Activity or condition exists up to 1/3 of the time.F Frequently Activity or condition exists from 1/3 to 2/3 of the time.C Constantly Activity or condition exists 2/3 or more of the time.

ENVIRONMENTAL CONDITION FACTORS AND DEFINITIONS

1. EXPOSURE TO WEATHER

Exposure to outside atmospheric conditions. In Part A, the rating for the Exposure to Weather component appears first in the Environmental Conditions column under the vertical heading We.

2. EXTREME COLD

Exposure to nonweather-related cold temperatures. In Part A, the rating for the Extreme Cold component appears second in the Environmental Conditions column under the vertical heading Co.

3. EXTREME HEAT

Exposure to nonweather-related hot temperatures. In Part A, the rating for the Extreme Heat component appears third in the Environmental Conditions column under the vertical heading Ho.

4. WET AND/OR HUMID

Contact with water or other liquids or exposure to nonweather- related humid conditions. In Part A, the rating for the Wet and/or Humid component appears fourth in the Environmental Conditions column under the vertical heading Hu.

5. NOISE INTENSITY LEVEL

The noise intensity level to which the worker is exposed in the job environment. This factor is expressed by one of five levels. In Part A, the rating for the Noise Intensity Level component appears fifth in the Environmental Conditions column under the vertical heading No.

Code Level Illustrative Examples1 Very Quiet isolation booth for hearing test; deep sea diving; forest trail

2 Quiet library; many private offices; funeral reception; golf course; art museum

3 Moderate business office where typewriters are used; department store; grocery store; light traffic; fast food restaurant at off-hours

4 Loud can manufacturing department; large earth-moving equipment; heavy traffic

5 Very Loud rock concert - front row; jackhammer in operation; rocket engine testing area during test

6. VIBRATION

Exposure to a shaking object or surface. In Part A, the rating for the Vibration component appears sixth in the Environmental Conditions column under the vertical heading Vi.

7. ATMOSPHERIC CONDITIONS

Exposure to such conditions as fumes, noxious odors, dusts, mists, gases, and poor ventilation, that affect the respiratory system, eyes, or the skin. In Part A, the rating for the Atmospheric Conditions component appears seventh in the Environmental Conditions column under the vertical heading AC.

8. PROXIMITY TO MOVING MECHANICAL PARTS

Exposure to possible bodily injury from moving mechanical parts of equipment, tools, or machinery. In Part A, the rating for the Proximity to Moving Mechanical Parts component appears eighth in the Environmental Conditions column under the vertical heading MP.

9. EXPOSURE TO ELECTRICAL SHOCK

Exposure to possible bodily injury from electrical shock. In Part A, the rating for the Exposure to Electrical Shock component appears ninth in the Environmental Conditions column under the vertical heading ES.

10. WORKING IN HIGH, EXPOSED PLACES

Exposure to possible bodily injury from falling. In Part A, the rating for the Working in High, Exposed Places component appears tenth in the Environmental Conditions column under the vertical heading HE.

11. EXPOSURE TO RADIATION

Exposure to possible bodily injury from radiation. In Part A, the rating for the Exposure to Radiation component appears eleventh in the Environmental Conditions column under the vertical heading Ra.

12. WORKING WITH EXPLOSIVES

Exposure to possible injury from explosions. In Part A, the rating for the Working with Explosives component appears twelfth in the Environmental Conditions column under the vertical heading Ex.

13. EXPOSURE TO TOXIC, CAUSTIC CHEMICALS

Exposure to possible bodily injury from toxic or caustic chemicals. In Part A, the rating for the Exposure to Toxic or Caustic Chemicals component appears thirteenth in the Environmental Conditions column under the vertical heading TC.

14. OTHER ENVIRONMENTAL CONDITIONS

Other Environmental Conditions, not defined above. These may include, but are not limited to, such settings as demolishing parts of buildings to reach and combat fires and rescue persons endangered by fire and smoke; mining ore or coal underground; patrolling assigned beat to prevent crime or disturbance of peace and being subjected to bodily injury or death from law violators; diving in ocean and being subjected to bends and other conditions associated with high water pressure and oxygen deprivation; patrolling ski slopes prior to allowing public use and being exposed to danger of avalanches. In Part A, the rating for the Other Environmental Conditions component appears last in the Environmental Conditions column under the vertical heading Ot.

Thirty Keys to RFC

Residual Functional Capacity is the individual’s maximum remaining ability to do sustained work activities in an ordinary work setting on a regular and continuing basis. A “regular and continuing” basis means eight hours a day, for five hours a week, or an equivalent work schedule (SSR 96-8p). RFC is an administrative assessment of the extent to which a person’s medically determinable impairment(s), including any related symptoms, such as pain, may cause physical or mental limitations or restrictions that may affect his/her capacity to do work-related physical or mental activities. RFC does not represent the least an individual can do despite his or her limitations or restrictions, but the most.

Continuing Disability Reviews depend on correct RFC articulation to determine if medical improvement has occurred.

Components of the RFC Assessment:

a. What the person can still do despite his/her limitationsb. Evaluation of the physical, mental and other limitations (i.e. postural/environmental) in the exhibit filec. Evaluation of the claimant’s symptoms, including pain

It is incorrect to find that an individual has limitations or restrictions beyond those caused by his or her medical impairment(s) (SSR 96-8p) but see SSR 02-1p for guidance on claims involving obesity

For each impairment that is found to be “severe”, one or more resulting limitations must be included in the RFC statement. This has been a primary basis for remand, according to OAO and OGC. Be particular to such as manipulative limitations when there is hand impairment; reaching limits if a shoulder injury.

RFC findings must be function by function statements – conclusive statements such as “less than sedentary”, “unable to sustain work activity”, “unable to work full-time”, and similar statements are not RFC findings. Encourage writers to build a bridge and path of reasoning from evident to RFC to decision without resort to just compact phrases in RFC. However, it is proper to state the RFC as a full range of work, i.e., Light, then address additional limitations as exceptions.

Look at the total evidentiary picture and determine how the various types of medical evidence fit together for RFC assessment: Some facts to consider are

a. number of hospital stays b. frequency of treatmentc. x-rays and other lab findingsd. medical and other opinionse. time frames, progression of an illnessf. prescription medication and side effects.

A Medical Source Statement or function-by-function medical report in the record is NOT required to determine RFC.

The ALJ decides and phrases the RFC. Clearly articulate the rationale for every part of the residual functional capacity (RFC ) finding in the written decision and include references to specific evidence in the record. Follow the ABCs of RFC – Always be Comprehensive, Always be Clear, Always be Consistent, emphasizing the regulations in 20 CFR 404.1545 and 416.945 and SSR 96-8p. To be clear, distinguish impairments, symptoms and the RFC assessment – capacities and limitations. If the ALJ has not provided a clear statement of the RFC in functional language, the writer should ask for clarification. The final written RFC assessment must include all of the limitations established by the evidence of record, including any caused by “non-severe” impairment(s).

Use of the FIT enhanced decisional instructions or electronic Bench Book (eBB) decisional instructions helps to ensure that the articulated limitations in the Step 3 “B” criteria are consistent with the articulation of severe impairments at Step 2 and with the limitations expressed in the RFC.

Although ALJs are required to consider the Disability Determination Services (DDS) consultant opinions, there are not bound by those opinions (20 CFR 404.1527 and 416.927). If the DDS doctor fails to provide support and/or an explanation for the functional limitations, the ALJ is entitled to give such limitations little or no weight.

A Single Decision Maker (SDM( assessment is not opinion evidence and should not be assessed as such in a decision

Be clear and precise in articulating RFC at hearing. Consistent use of forms and accurate note taking are helpful. Don’t assume the writer will listen to a hearing recording, or that others will document the RFC. The Findings Integrated Template (FIT) decisional template will state the complete RFC once in a decision, to minimize potential inconsistency error.

Do not allow the claimant or representative to ask improper hypothetical question using undefined terms. The ALJ may explain the rationale behind the ruling to assist reviewing bodies and may try to assist the representative with rephrasing a question that states, in functional terms, the effect of a symptom or medication on the ability to perform basic work activities

a. Use precise terms which mean the same to all

b. Use clearly defined terms from the regulations, rulings, Dictionary of Occupational Titles, and Selected Characteristics of Occupations, such as “occasional”, “frequent”, “never”, etc. when possible

c. Use quantifiable terms such as the specific amount of time in minutes, hours, days, or the percentage of a workday or workweek, when possible

Do not use vague or imprecise terms such as “moderate”, “fair”, “low”, “mild”, “marked”, “reasonable”, “unreasonable”, “excessive”, and similar terms in the RFC statement. Especially with mental impairments, moderate ability to handle stress, and moderately impaired concentration are too imprecise.

Many vocational experts testify that DOT General Educational Development (GED) levels 1, 2, and 3 are compatible with DOT Specific Vocational Preparation (SVP) levels 1 and 2, as simple, unskilled work, although some testify that reasoning level 3 is not incompatible with “simple” work. There is not a standard view on this.

The RFC in the decision rationale and in the decision rationale must be the same.

RFC that falls between the full range of light and sedentary work is light as to lift, carry, push and pull, even if the claimant is limited to only 2 hours standing and walking in an 8-hour workday.

For the sit/stand option, specify how long the claimant can remain in each position at one time, and the total amount of time the claimant can be in this position in an 8-hour day. Consider these as “base” and “relief” postures.

For the use of a cane or other hand-held assistive device, there must be medical documentation establishing the need, and the circumstances for which it is needed must be clear:

a. Needed for balancing, standing, walking, or all of these,

b. Needed for walking more than a certain distance (give the distance), or

c. Needed for walking on rough or uneven surfaces, on ascending or descending slopes, or under other conditions (specify the conditions).

d. Use of an assistive hand-held device, such as a cane or walker, “may also impact on the individual's functional capacity by virtue of the fact that one or both upper extremities are not available for such activities as lifting, carrying, pushing, and pulling.” Appendix 1 to Subpart P of Part 404, 1.00 B.2.b and J.4.

For terms that do not have a legally recognized definition, use an alternative that SSA recognizes from the DOT, such as stoop for bend, crouch for squat, and handle (gross manipulation) and finger (fine manipulation) when describing grip. Limitation of the ability to perform fine manipulation is increasingly important as the exertional level decreases. If only one hand/arm is involved, explain the extent of limitation, identify the hand/arm impacted, and indicate whether it is dominant.

Inability to maintain balance when walking or standing on straight, level surfaces would result in significant erosion of the occupational base at all levels. So, be sure to specify the nature of the limitations on the ability to balance.

Though a claimant is disabled on physical factors alone, it is necessary to address the mental limitations (20 CFR 404.1520a and 416.920a).

The “B” criteria of the PRTF and MRFC pages 1 and 2 are not RFC statements, those pages identify areas of functioning affected by the mental impairment but do not state limitations in functionally defined terms. So, terms used to describe limits should not appear in an RFC, unless clearly defined functionally for the particular case.

Reference to “concentration, persistence, or pace” does not specify the nature or scope of the work-related limitation(s). Use language such as, “the individual would require task reminders from the supervisor 10 times during each 8-hour day”.

There is a difference between simple work and simple routine work. Routine work could be defined as repetitive work done in a relatively unchanging environment (see SSR 85-15 for the basic mental demands of competitive, remunerative, unskilled work).

Clarifying terms such as “complex”, “complicated” and “production rate pace” from the DOT can be useful to explain RFC, particularly with non-exertional limitations. (DOT Appendix B, C and D).

It may be helpful to phrase a concentration, persistence, or pace hypothetical for a specific period of time, such as 2-hour blocks, because of the customary work breaks at mid-morning, lunch and mid-afternoon.

With respect to “low stress” work, the stress-related limitation must be due to a Medically Determinable Impairment (MDI). Examples of workplace stressors:

a. working with the general public

b. working with co-workers

c. working with close supervision,

d. making decisions

e. dealing with change in the workplace

f. work around hazards, production rate pace

g. using judgment.

For example, “The claimant can have occasional contact with co-workers and the general public”.

There is no SSR that defines how often a person can be off task and still maintain employment.

The SCO defines near and far visual acuity (clarity), depth perception, field of vision, and accommodation (adjustment of the lens to bring an object into focus). RFC example: “The individual has limited depth perception such that he is unable to make accurate judgments of distance and speed”.

As a general rule, even if a person’s visual impairment(s) were to eliminate all jobs that involve very good vision (such as working with small objects or reading small print) as long as he or she retains sufficient visual acuity to be able to handle and work with rather large objects (and has visual fields to avoid ordinary hazards in a workplace), there would be a substantial number of jobs remaining across all exertional levels (SSR 85-15).

In assessing RFC with impairments of hearing or speech, explain how the limitations affect communication in the workplace. Generally, basic communication is all that is needed to do unskilled work. Use the SCO Noise Intensity Level with illustrative examples. Pertinent attributes of speech are audibility, intelligibility, and functional efficiency.

The terms “moderate exposure” and “concentrated exposure” to environmental conditions are not defined in the DOT or SCO. These terms are modifying the level of exposure, so the frequency of exposure may also be relevant and can be defined by terms “occasional”, “frequent,” or “constant”.

Use terms that attempt to describe the degree of limitation, like “mild”, “moderate”, “marked”, “severe” or “extreme” only when they are specifically defined by reference to a particular source, and with respect to specific work-related limitations. Set forth the maximum capability for each work activity. For example, “the individual is able to sit for up to six hours total, and can sit for three hours at a time”. Why not state this as frequent or occasional?

For unclear terms such as “limited”, “somewhat”, and “reasonable”, describe the nature of the limitation or the circumstances in which it applies. Answer this: In what way or ways is the claimant limited in performing this work-related function?

Instead of using terms like “probably”, “possibly” and “may”, determine whether or not there is a limitation, based on the preponderance of the evidence, and describe the nature, scope and frequency of the limitation.

Terms like “repetitive” do not describe frequency, only that there is a repetition at some unknown interval. For limitations that occur “at times” use terms that are recognized in SSA such as occasionally and frequently.

If you are tempted to state the claimant is “not significantly limited in the ability to do X”, that is probably not a limitation worthy of mention.

RFC Case Studies

1. Severe: borderline intellectual functioning, personality disorder. While intellectually limited, claimant has the cognitive ability to remember general work procedures, and to understand and remember general work procedures, and to understand and remember instructions for simple tasks of a routine and repetitive nature. While distractible, she has attention and concentration for tasks which are simple and repetitive. While she is easily angered, claimant should be able to handle supervisory contacts which are time limited and task focused. Claimant would do best with employment that provides for a relatively isolated work setting. She would be able to react and adapt appropriately to low stress work environment.

2. Severe: anxiety disorder and major depression. The claimant can perform a full range of exertional work, except she can understand and remember simple instructions, but may have difficulty with more detailed instructions. She can complete simple tasks, but may have difficulty maintaining attention and concentration for extended periods. She can cooperate and be socially appropriate in low stress environments.

3. Severe: history of cerebrovascular accident, hypertension, tobacco abuse. The RFC is less than a full range of sedentary work defined in 20 CFR 416.967(a). The claimant can frequently lift and/or carry 10 pounds, stand and/or walk for 2 hours during an 8-hour workday, and sit for 6 hours in an 8-hour workday, using an assistive device. Postural movements are limited to less than occasionally. Claimant is limited to performing simple one, two or three step job tasks or instructions and work that does not require the ability to speak or for her speech to be understood.

4. Severe lumbar spine degenerative disc disease, hepatitis C and depression. The claimant can perform a full range of light exertional work, except he has the ability for limited bending and squatting and is able to work with supervisors and co-workers, but should have limited contact with the public, alternate sitting/standing as needed; simple, routine, repetitive tasks and low stress, meaning no production pace work or excessive noise.

5. Severe bilateral carpal tunnel syndrome and adhesive capsulitis of the left shoulder. The claimant can perform light work with limited gripping, bilaterally.

6. Severe degenerative disc disease of the cervical spine and osteoarthritis of the knees. RFC is for light work except the individual can lift and carry 10 lbs. occasionally and frequently; walk for 50 feet at a time and then must rest for 3-5 minutes before walking can resume; walk a maximum of 300 feet in an 8-hour period; a wheelchair is required for ambulating long distances; stand for 10 minutes at a time before resting for 20-30 minutes before standing can resume; stand for one hour and 20 minutes in an 8-hour period.

7. Severe monocular vision, seizure disorder, carpal tunnel syndrome, dysthymia, borderline intellectual functioning. The claimant can perform light work, sit/stand option at will; no climbing ladders, ropes, or scaffolds; frequent bilateral fingering and handling; simple, routine, repetitive tasks with reasonable reminders by the supervisor.

8. Severe asthma and cardiomyopathy. RFC: Must avoid concentrated exposure to respiratory irritants and, therefore, is unable to work in an ordinary setting on a regular and continuing basis, 8 hours a day, 5 days a week or an equivalent work schedule.

9. Severe obesity, mood disorder and osteoarthritis. The individual can do the full range of light work, except for a difficulty balancing and capacity for only occasional fingering and handling, but due to the effects of depression is likely to miss work or be inattentive to job duties on average one day a week.

10. Severe psychotic disorder NOS, rule out substance induced. He is able to follow and understand simple directions and instructions, perform simple tasks independently, maintain attention and concentration, maintain a regular schedule, learn new tasks, relate adequately with others, and appropriately deal with stress within normal limits. Mild impairment is demonstrated in performing complex tasks independently and making appropriate decisions. The difficulties are caused by chronic cocaine and alcohol use.

Name: SSN: AOD:

ALJ: Scheduled: Amended AOD:

Case Characteristics:

HYPO-1EXERTIONAL CATEGORY

Limitations:⃝U Less than Full Range of Sedentary⃝U Less than Full Range of Light⃝U Less than Full Range of Medium⃝U Non-Exertional Only⃝U Not Answered

WITH THE ADDITIONAL LIMITATIONS INDICATED BELOW:

EXERTIONAL LIMITATIONSLift/Carry

Lift

Unlimited 50 lbs. 25 lbs. 20 lbs. 10 lbs. OtherOccasionally ⃝U ⃝U ⃝U ⃝U ⃝U ⃝U

Frequently ⃝U ⃝U ⃝U ⃝U ⃝U ⃝U

Carry

Unlimited 50 lbs. 25 lbs 20 lbs 10 lbs OtherOccasionally ⃝U ⃝U ⃝U ⃝U ⃝U ⃝U

Frequently ⃝U ⃝U ⃝U ⃝U ⃝U ⃝U

Sit/Stand/WalkSit ⃝U Unlimited ⃝U 7 hrs ⃝U 6 ⃝U 5 ⃝U 4 ⃝U 3 ⃝U 2 ⃝U 1 ⃝U Other

Alternate to sitting for U Hrs UMins after every U Hrs U Mins of Sitting

Stand ⃝U Unlimited ⃝U 7 hrs ⃝U 6 ⃝U 5 ⃝U 4 ⃝U 3 ⃝U 2 ⃝U 1 ⃝U Other

Alternate to standing for U Hrs UMins after every U Hrs U Mins of Standing

Walk ⃝U Unlimited ⃝U 7 hrs ⃝U 6 ⃝U 5 ⃝U 4 ⃝U 3 ⃝U 2 ⃝U 1 ⃝U Other

Alternate to walking for U Hrs UMins after every U Hrs U Mins of Walking

Push/Pull⃝U As much as can lift/carry U Other

FootControls

Unlimited Frequent Occasional Never OtherRight ⃝U ⃝U ⃝U ⃝U ⃝U

Left ⃝U ⃝U ⃝U ⃝U ⃝U

HandControls



MANIPULATIVE LIMITATIONS

Reach(Overhead)



Reach(All Other)



Handle



Finger



Feel



POSTURAL LIMITATIONS

Climb Ramps & Stairs

Unlimited Frequent Occasional Never Other⃝U ⃝U ⃝U ⃝U ⃝U

Climb Ladders, Ropes or Scaffolds


Balance


Stoop


Kneel


Crouch


Crawl


COMMUNICATIVE & VISUAL LIMITATIONS

Communication

⃝U Unlimited⃝U Limited to hearing and understanding simple oral instructions⃝U Limited to communicating simple information⃝U Limited to hearing and understanding simple oral instructions and to communicating information⃝U Limited as follows

Vision

⃝U Unlimited⃝U Limited to reading ordinary newspaper or book⃝U Limited avoiding ordinary hazards in the workplace (e.g. boxes on floor, doors ajar, etc.)⃝U Limited as follows

ENVIRONMENTAL LIMITATIONS

Unprotected Heights


Moving Mechanical Parts


Operating a Motor Vehicle


Weather


Humidity and Wetness


Dust, Odors, Fumes and Pulmonary Irritants


Extreme Cold


Extreme Heat


Vibration


Noise

Very Loud Loud Moderate Quiet Other⃝U ⃝U ⃝U ⃝U ⃝U

Other

Very Loud Loud Moderate Quiet Other⃝U ⃝U ⃝U ⃝U ⃝U

MENTAL LIMITATIONS

Understand, Remember & Carryout Instructions

⃝U Unlimited⃝U Limited to perform simple, routine tasks⃝U Limited to perform simple, routine and repetitive tasks⃝U Limited to perform simple, routine and repetitive tasks but not at a production rate pace(e.g. assembly line work)⃝U Limited to simple, routine, repetitive tasks and requires reminders to perform tasks as follows

⃝U Limited as follows

Use Judgment

⃝U Unlimited⃝U Limited to simple work-related decisions⃝U Limited as follows

Respond Appropriately to Supervision, Coworkers, & Work Situations

Unlimited Frequent Occasional Never OtherSupervisors ⃝U ⃝U ⃝U ⃝U ⃝U

Coworkers ⃝U ⃝U ⃝U ⃝U ⃝U

Public ⃝U ⃝U ⃝U ⃝U ⃝U

Dealing with changes in Work Setting

⃝U Unlimited⃝U Limited to simple work-related decisions⃝U Limited to tolerating few changes in a routine work setting defined as

Other

OTHER LIMITATIONS

Time Off Task

⃝U Unlimited⃝U Time off task can be accommodated by normal breaks⃝U Limited to perform simple, routine and repetitive tasks⃝U In addition to normal breaks, off task percent of time in 8-hour workday⃝U Limited as follows

Absences

⃝U Unlimited⃝U Absent from work 1 day a month⃝U Absent from work 2 days a month⃝U Absent as follows

Other

· web viewin the preceding chart, lifting, pushing, and pulling are expressed in terms of both...

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