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How to fill out the Residual Functional Capacity Form online
This guide provides a step-by-step approach to completing the Residual Functional Capacity Form online. By following the instructions outlined below, users can ensure accurate and comprehensive submissions that support their claims.
Follow the steps to efficiently fill out the Residual Functional Capacity Form online
- Click the ‘Get Form’ button to access the Residual Functional Capacity Form online and open it in the designated editor.
- Begin by entering the Social Security Number (SSN) in the designated field at the top of the form.
- Fill in your name and, if applicable, the name of the individual involved in the claim.
- Complete the section regarding the medical consultant's review, ensuring to identify whether it is completed by the Disability Determination Services (DDS) or the regional office (RO).
- Specify the date when the SSA-4734-F4-SUP is being reviewed and indicate the type of claim, selecting either initial or continuing disability review (CDR).
- In Section I, indicate your agreement or disagreement with the four areas assessed from the Narrative Statement of the mental RFC using checkmarks. Ensure you are precise with your selections.
- If there is disagreement, provide a comprehensive explanation in Section II. Detail the basis for disagreement for each mental area marked in Section I and include any necessary evidence.
- At the end of the form, review all entries for accuracy. Users can save changes, download, print, or share the completed form as needed.
Complete your documents online today to ensure a smooth review process.
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Who Can Fill Out an RFC Form? A doctor who submits a residual functional capacity form should be a treating physician. A treating physician is qualified to perform an evaluation as to the claimant's medical condition and how the condition affects the claimant because the doctor has a history with the claimant.
Fill Residual Functional Capacity Form
Please respond to the following questions regarding your patient¶s disability. Form SSA-4734-BK (08-2017). Discontinue Prior Editions. Your Residual Functional Capacity is the maximum amount of work you can still do despite your limitations. Find the appropriate Residual Functional Capacity Forms. Contact SSD attorney Mike Murburg, P.A. at for more information. The RFC form will contain a list of work activities that you can perform as well as restrictions on what you can't do because of your condition. RFC is the maximum amount of work you can still do despite your limitations. A mental RFC involves Form SSA-4734-F4-SUP. A psychologist or psychiatrist most commonly completes this form.
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