Residual Functional Capacity Assessment for Parkinson's Disease
What Is Residual Functional Capacity?
If your Parkinson's disease 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.
Residual functional capacity is a claimant’s ability to perform work-related activities. In other words, it is what you can still do despite your limitations. A residual functional capacity 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. The lower your residual functional capacity, the less the Social Security Administration believes you can do.
Parkinson's disease that does not meet or equal the listing will require some lowering of residual functional capacity.
Tremors or Bradykinesia
Particular attention should be paid to the presence of tremors or bradykinesia, since not only fine manipulation but task speed can be influenced. However, any claimant who has a significant manipulatory loss in addition to inability to stand/walk 6–8 hours daily should not even reach the residual functional capacity step in adjudication because disability benefits should be allowed by meeting the listing.
People with Parkinsonism may have significant autonomic abnormalities such as temperature intolerances that require environmental restrictions. Sensory symptoms or stiffness in the fingers could affect fine manipulatory ability in the absence of tremors or bradykinesia.
Also, because of postural, balance, and gait problems, claimants with Parkinsonism should be restricted from working at unprotected heights.
Stiffness and rigidity can limit the amount of time you can push and pull, as with arm or leg controls, and can therefore limit the range of work you can perform.
Any information you can provide regarding functional abilities in regard to daily activities can be most helpful, especially specific examples like “I was a mechanic, but now my hand shakes too much to turn a nut.” Any symptoms you can describe in regard to walking, such as freezing and easy fatigability would be arguments against the ability to do prolonged standing.
The Social Security Administration should not use ability to walk around the home or in the doctor’s examining room as evidence of ability to perform a light work or higher residual functional capacity, unless the medical evidence as a whole supports the ability for prolonged standing or walking.
Disorders that produce hereditary Parkinsonism, Parkinsonism-plus, and secondary Parkinsonism are likely to involve other impairments and limitations that are in addition to your overall severity as a result of Parkinson’s disease. These additional impairments could themselves qualify under a different listing or result in equivalent severity by their combination.
Continue to Getting Your Doctor's Medical Opinion About What You Can Still Do or Parkinson's Medical Source Statement.
Go back to How to Get Disability Benefits for Parkinson's Disease by Meeting a Listing..