Residual Functional Capacity Assessment for HIV & AIDS
What Is RFC?
If your HIV infection is not severe enough to meet or 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.
Physical and Mental RFC
An RFC for physical impairments is expressed in terms of whether SSA believes you can do heavy, medium, light, or sedentary work in spite of your impairments. The lower your RFC, the less the SSA believes you can do.
An RFC for mental impairments is expressed in terms of whether Social Security Administration believes a claimant can do skilled, semi-skilled, or unskilled work in spite of impairments, or whether the claimant cannot even do unskilled work.
Activities of Daily Living
If your condition is not severe enough to meet or equal a listing, it is very important to provide the Social Security Administration with your symptoms and specific examples about how those symptoms limit your activities of daily living.
Many people with HIV infection have no symptoms before the onset of opportunistic diseases. Some complain of nonspecific symptoms of malaise and fatigue before the onset of any major physical impairment or opportunistic infection. To some extent their activities of daily living may be reduced, but not markedly limited. If you have no symptoms and your immune system is intact, you will not be limited in the work you can do and would not require any RFC. However, if your disease is more advanced and you have medically severe associated symptoms, they could warrant an RFC reduction.
Effect of Medications
The Social Security Administration should take into account that your medications alone can produce extreme fatigue. You may have mental problems either from the effects of HIV directly on the brain, drug side-effects, or impairments arising in association with AIDS. If there is any question about your mental state, family members, friends, or other individuals in contact with you should be asked about symptomatic problems you may be having and how they are functionally limiting.
Ability to Walk, Lift and Carry
If your condition is close to listing-level severity, you should receive no higher than a sedentary RFC. The most significant question is “Can you stand or walk 6 – 8 hours daily?” If not, your RFC will reduce to sedentary work. You should also be asked about your ability to lift and carry. It can be helpful if you can name objects of known weight that you can no longer lift, and activities requiring a particular amount of lifting and carrying that you can no longer do.
The importance of providing the Social Security Administration with your current weight cannot be over-emphasized. Malnutrition and accompanying easy fatigability can significantly limit exertional capacities even without consideration of other limiting factors.