How Social Security rates your ability to do things will determine how your case is decidedWhen you apply for disability, SSA gathers your medical records and determines how limited you are in your ability to perform normally daily activities. When it comes to physical capacity, they look at a wide variety of functions (here, we are referring to just physical limitations, but there is a separate process for evaluating mental limitations also), but it always comes down to a rating of sedentary, light, or medium. To simplify things a bit, if you get a sedentary RFC, it means SSA thinks you can do sedentary work but nothing more than that. If you get a light RFC, it means that SSA thinks you can do light work, but nothing more than that. If you get a medium RFC, it means that SSA thinks you can do medium work but nothing more than that. Obviously, it will be in the person's best interests to have the most restrictive RFC possible because with more restrictions you are considered to have less of a realistic chance of being able to work. That is why a light RFC makes a case stronger than a medium RFC. A sedentary RFC makes a case stronger than either a light or medium RFC. A medium RFC means that Social Security believes that the person has the capability of lifing 25 lbs frequently and 50 lbs occasionally. That determination can be made by a judge at a hearing, or if the case is at the application level or reconsideration appeal level, it can be made by a disability examiner. Now, on the subject of a medium RFC, I have a gripe. I said a long time ago that doctors who work on SSD and SSI disability cases at disability determination services should be required to have a 50 lb dumbbell beside their desk. Why? To let them know what fifty pounds really is. Because, honestly, I don't think most of them know how much stress having to lift fifty lbs occasionally as part of one's job duties (a medium RFC entails lifting 25 lbs frequently and 50 lbs occasionally) actually puts on the body. A lot of them, I'm sure, would have trouble picking up a 50 pounder even once. And I am fairly certain this would affect how often they dole out medium RFC ratings to claimants with significant back problems such as lumbar degenerative disc disease. Think about it. You can't really feel someone else's pain. No matter how much you hear their expression of it. In fact, it's a psychological phenomenon that the more we hear someone's complaints of pain and discomfort, the more desensitized we become to them. So, what does this mean for the disability evaluation system? Well, doctors who routinely see patients with painful conditions for which the treatment options are either limited or exhausted tend to become "distanced" (back pain, fibromyalgia, etc). But, also, (in my opinion), disability examiners who tend to be younger individuals probably have less empathy toward many conditions simply because, as a group, their average age precludes having experienced a lot of pain and impairment. Some may object to my inference that the disability system is less than objective. But it is a very subjective system, despite the blue book and the grid. If it wasn't then there wouldn't be this huge chasm of disconnect between cases that are denied at the reconsideration level and cases that are later approved at a disability hearing. About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here. 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