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Residual Functional Capacity Questionnaire Name of Individual: Social Security Number: The Residual Functional Capacity Questionnaire (RFC) is used to assess Attachphysical Please answer the following.

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(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.

Again, in determining your RFC, Social Security must take into account all of your symptoms and limitations, both physical and psychological. If your symptoms and limitations would make you unable to perform even sedentary work, then Social Security should determine that you are disabled.

The Disability Determination Services (DDS) physician completes the RFC form, but you can also have your own doctor fill out an RFC on your behalf.

This may include whether they are unable to lift or carry items above a certain weight, whether they can walk or stand for long periods of time, whether they experience pain or discomfort when sitting or remaining in the same position while working, and whether they can bend over, kneel, crawl, or reach for objects.

RFC exertional classifications are: Very heavy work. This kind of work requires standing or walking for six or more hours and lifting 100 pounds or more. Heavy work. This is work that requires standing or walking for six or more hours and lifting weights of no more than 100 pounds. Medium work. ... Light work. ... Sedentary.

Examples of physical residual functionality include whether the applicant is able to lift or carry items over a certain weight, whether they can stand or walk for an extended period(s) of time, whether they experience discomfort or pain when staying in the same position or sitting while working, and whether they can ...

RFC is an administrative assessment of the extent to which an individual's medically determinable impairment(s), including any related symptoms, such as pain, may cause physical or mental limitations or restrictions that may affect his/her capacity to do work-related physical and mental activities.

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.

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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
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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