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  • Ssa-4734-bk. Physical Residual Functioning Capacity Assessment

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Form SSA4734BK (082017) Discontinue Prior Editions Social Security AdministrationPage 1 of 7PHYSICAL RESIDUAL FUNCTIONAL CAPACITY ASSESSMENT SOCIAL SECURITY NUMBERCLAIMANT: NUMBERHOLDER (IF CDB OR.

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When applying for disability benefits, your Social Security doctor may need to fill out some Social Security forms. These forms include a residual functional capacity form, medical evaluation report, and more.

An RFC form assesses a disability claimant's "residual functional capacity," the ability to work that remains after taking into account the claimant's mental or physical disability.

Form SSA-16 | Information You Need to Apply for Disability Benefits | Social Security Administration.

Form SSA-16 | Information You Need to Apply for Disability Benefits | Social Security Administration.

You can request the RFC form from your local Social Security office or you can download it directly from the Social Security website. Once you have obtained the form, take it with you to your doctor's office and have them complete the form for you.

You can request the RFC form from your local Social Security office or you can download it directly from the Social Security website. Once you have obtained the form, take it with you to your doctor's office and have them complete the form for you.

(a) General (1) Residual functional capacity assessment. Your impairment(s), and any related symptoms, such as pain, may cause physical and mental limitations that affect what you can do in a work setting. Your residual functional capacity is the most you can still do despite your limitations.

While a doctor's letter may be a deciding factor in a disability claim, it is not enough to state that you are completely disabled and unable to work. This type of statement can actually hinder your case. In any event, a doctor's letter should not be included with the initial application.

It is your responsibility to have your physician/practitioner complete and sign the form and submit it to us within 49 days from the date your disability begins or you may lose benefits. Have your physician/practitioner complete the medical certification portion of your disability claim.

No, doctors are not required to fill out disability forms. Your doctor can refuse to complete your form. When this happens, your chances of approval diminish.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232