Residual Functional Capacity Assessment for Fibromyalgia
What Is RFC?
If your fibromyalgia is not severe enough to equal a listing at Step 3 of the Sequential Evaluation Process, the Social Security Administration will need to determine your residual functional capacity (RFC) to decide whether you are disabled at Step 4 and Step 5 of the Sequential Evaluation Process.
RFC is a claimant’s ability to perform work-related activities. In other words, it is what you can still do despite your limitations. An RFC for physical impairments is expressed in terms of whether the Social Security Administration believes you can do heavy, medium, light, or sedentary work in spite of your impairments. An RFC for mental impairments is expressed in terms of whether Social Security Administration believes the claimant can do skilled, semi-skilled, or unskilled work in spite of impairments, or whether the claimant cannot even do unskilled work. The lower your RFC, the less the Social Security Administration believes you can do.
RFC and Fibromyalgia
If you have fibromyalgia, you may have significant residual limitations that could potentially result in allowance of your claim.
In determining your RFC, the Social Security Administration adjudicator should consider all of your symptoms in deciding how they may affect your ability to function. Symptoms of fibromyalgia that the adjudicator should consider include those mentioned in the American College of Rheumatology’s definition of fibromyalgia:
- Widespread pain in all four quadrants of the body
- As many as are present of the 18 specified tender points around the neck and shoulder, chest, hip, knee, and elbow regions.
Other typical symptoms that could limit you functional capacity include:
- Irritable bowel syndrome.
- Chronic headaches.
- Temporomandibular joint dysfunction.
- Sleep disorder.
- Severe fatigue.
- Cognitive dysfunction.
The Social Security Administration has issued a ruling that provides guidance to Social Security Administration adjudicators about what to consider in assessing a fibromyalgia claimant’s RFC. In evaluating the credibility of the symptoms you report, the adjudicator should ask your treating doctor or other medical sources to provide information about the extent and duration of your impairments, including observations and opinions about how well you are able to function, the effects of any treatment, including side effects, and how long the impairments are expected to limit your ability to function.
Opinions from your medical sources, especially treating doctors, concerning the effects of fibromyalgia on your ability to function in a sustained manner in performing work activities or in performing activities of daily living are important in enabling adjudicators to draw conclusions about the severity of your impairments. Any information a medical source is able to provide contrasting your impairments and functional capacities since the onset of your fibromyalgia with your status before its onset will be helpful in evaluating your impairments and their functional consequences. See Getting Your Doctor’s Opinion About What You Can Still Do.
Information from third-parties may be very useful in deciding your credibility. Information other than your allegations and reports from your treating doctors helps the adjudicators to assess your ability to function on a day-to-day basis and to depict your capacities over a period of time. Such evidence includes, but is not limited to:
- Information from neighbors, friends, relatives, or clergy.
- Statements from past employers, rehabilitation counselors, or teachers about your impairments and their effects on how your function in the workplace, rehabilitation facility, or educational institution.
- Statements from health care professionals who have treated you, other than doctors, such as nurse-practitioners, physicians’ assistants, naturopaths, therapists, social workers, and chiropractors.
- Your own record (such as a diary, journal, or notes) of your impairments and their impact on function over time.