Hearing Questions on
Physical Residual Functional Capacity
by Thomas E. Bush
Excerpted from Social Security Disability Practice
Sitting, standing, walking, lifting, manipulating, traveling, good/bad days, etc.
The following outline for questioning
about physical capacity deals with the most common physical RFC issues.
For a list of additional postural, manipulative, visual, communicative
and environmental limitations, see the Physical RFC Assessment Form,
Form SSA-4734-U8, §206.1, supra.
Be sure to preface your
questioning of the claimant concerning his RFC with the explanation that
you are interested in his best estimate of his capacity to do these
activities on a day-to-day basis, 8 hours per day, 5 days per week,
approximately 50 weeks per year in a regular work setting. Encourage
your client to volunteer examples of his limitations when answering RFC
questions.
§318.1 Sitting
1. Do you have any problem with sitting?
2. How long can you sit:
-
continuously in one stretch?
-
total during an eight-hour working day (with normal breaks)?
3. When you sit, can you sit:
-
without squirming?
-
without leaning on elbows?
-
at a desk:
—in an armless office chair?
—in an office chair with arms?
—on a backless stool?
• at a bench:
—on a high backless stool?
—on a high stool with a back?
• in a work-like
position:
—with your arms extended?
—with hands available to manipulate objects?
—with neck slightly bent forward?
4. If pain limits your sitting tolerance, describe:
• changes in the pain:
—onset
—the way the pain feels (type or quality of pain)
—radiation
—intensity
• how you try to
control the pain:
—shifting position in chair?
—leaning?
—getting out of the chair?
5. If you must get out of the chair:
• how long can you sit
before getting up?
must you:
—stand?
—walk?
—lie down?
• how long is it
before you can resume sitting?
6. When you sit is it necessary for
you to elevate a leg? If so,
-
which leg?
-
why?
-
how long must you elevate it?
-
how high?
7. When you get up from sitting:
-
do you need help getting up?
-
do you have difficulty standing when you first get up?
—Why? e.g., dizziness, stiffness, pain?
—How long does this problem last?
8. What happens if you try to sit too
long?
9. Give examples of sitting;
limitations:
-
driving or riding in a car
-
sitting at the dining room table:
—eating
—paying bills
-
watching a movie
-
watching television
-
doing crafts
-
fishing
10. Have you had to give up or limit
any hobbies because of your problem with sitting?
§318.2 Alternate Sitting,
Standing and Walking
1. Can you alternate sitting with standing? If so:
-
how often do you need to stand?
-
how long must you stand before resuming sitting?
-
can you work at a bench while standing?
—does it depend on the height of the bench?
• can you get
through an eight-hour working day alternating sitting and standing? If
not, how many hours total?
2. Is it necessary for you to alternate periods of
sitting with periods of walking?
-
why?
-
how often do you need to walk?
-
how long, must you walk before you can resume sitting?
-
can you get through an eight-hour working day alternating sitting and walking? If not, how many hours total?
§318.3 Standing
1. Do you have any problem with standing?
2. How long can you stand:
-
continuously in one stretch?
-
total during an eight-hour working day?
3. When you stand, can you stand:
-
without, for example, moving away from a machine?
-
without leaning against something?
-
in a work-like position:
—with your arms extended?
—with hands available to manipulate objects?
—with neck slightly bent forward?
4. What happens if you try to stand
too long?
5. Examples of standing limitations:
-
Waiting in line
-
standing at the stove to cook
-
doing dishes at the sink
-
waiting for a bus.
§318.4 Walking
1. Do you have any problem with
walking?
2. How long/how far can you walk:
-
continuously in one stretch without stopping to rest?
-
total during an eight-hour working day?
3. Can you walk:
-
without an assistive device?
-
at a normal speed?
4. What happens if you try to walk too far?
5. Do you have any problem keeping your balance on a
slippery or moving surface?
6. Examples of walking limitations:
• walking the aisles at a grocery
store
• walking around the neighborhood
§318.5 Lifting and Carrying
1. Do you have any problem with lifting or carrying?
2. How much can you lift or carry:
-
if you only had to do it for up to one-third of a work day?
-
if you had to do it from one-third to two-thirds of a work day?
3. What is the heaviest thing you encounter in your
daily life that you can still lift and carry?
4. Describe how you lift/carry these objects.
5. What sorts of things that you encounter in your daily
life can you no longer lift and carry?
6. What happens when you try to lift or carry too much?
§318.6 Postural Limitations
1. Describe any difficulty:
-
bending at the waist
-
twisting
-
stooping (bending the spine)
-
kneeling (bending the legs)
-
crouching (bending both the spine and the legs)
-
climbing stairs
-
climbing a ladder
-
other climbing
-
crawling
2. Can you do these activities:
-
up to one-third of a working day?
-
from one-third to two-thirds of a working day?
3. What happens if you overdo any of these activities?
§318.7 Manipulative Limitations
1. Are you left or right-handed?
2. Describe any difficulty using your hands and arms
for:
-
reaching all directions, including overhead
-
handling objects (gross manipulation)
-
fingering (fine manipulation)
-
feeling
-
pushing or pulling
-
twisting the wrists
-
working with hand tools, e.g., screwdrivers, pliers.
3. Do you have any problem with dropping things?
4. Do your hands ever shake? go numb? have a pins and
needles sensation?
5. How well can you perform the following?
-
opening a jar
-
opening a door
-
buttoning clothes
-
picking up coins
-
writing
-
washing the dishes.
6. Can you do repetitive hand
activities for most of an eight-hour working day?
§318.8 Traveling
1. How did you get to this hearing today?
2. How often have you left your home
during the past (month) (year)?
3. When you go out:
-
Where do you go?
-
Do you usually go alone?
4. If you usually have someone with
you when you go out, why don’t you go alone?
5. Do you have emotional problems
when you leave your home alone?
• If so,
describe the feelings you have and why it is difficult to leave your
home alone.
6. Do you have a driver’s license?
• If no,
have you ever had a driver’s license?
• Why don’t
you have one now?
7. Do you have any special restrictions on your driver’s
license? For example:
-
glasses
-
times of day,
-
speed,
-
distance?
8. Do you have a handicapped parking permit?
9. Do you have regular access to an automobile?
-
Does it have a standard or automatic transmission?
-
Does it have power or regular brakes and steering?
10. How is driving different for you now than before
your health problems became severe?
11. How often do you drive?
12. How long (or far) can you tolerate driving before
you have to stop and rest?
• How long
must you rest?
13. What is the greatest distance (or longest time) you
have driven in the last year?
-
Did you have to stop during this trip?
-
How many times and for how long?
14. Describe any difficulties with:
-
getting into or out of a car;
-
turning your head from side to side;
-
looking behind you when you drive in reverse;
-
sitting while you drive;
-
using your legs while driving;
-
using your arms or hands while driving
-
vision.
15. Do you have emotional problems while driving? For
example,
-
mental confusion?
-
nervousness or fear?
-
getting lost?
-
difficulty keeping your concentration and
-
attention?
16. Are you taking any medications:
-
which affect your driving
-
about which you have been warned that you should not drive while taking them?
-
If so, what are these medications?
17. If you have problems driving, how do you get around?
18. Do you have problems being a passenger in a car,
either physically (e.g., getting in and out, prolonged sitting) or
emotionally (e.g., paranoia, anxiety)?
19. Do you ride the bus or use any other public
transportation?
• If so,
how often?
20. Do you have dffficulties taking a bus, such as:
-
walking to the bus stop?
-
standing waiting for the bus?
-
climbing the steps into the bus?
-
sitting on the bus?
-
standing on the bus?
-
Have you ever fallen while on a bus?
21. Do you have any emotional
problems riding buses?
• If a
bus is crowded, do you feel anxious or paranoid?
22. Have you ever gotten lost or missed your stop while
riding a bus?
-
What happened?
-
How often has this happened?
§318.9 Good Days/Bad Days
If your capacity widely varies:
• Categorize your days, for example:
—good days/bad days
—good days/so-so days/bad days.
-
Describe each kind of day.
-
What are you capable of doing on each kind of day?
-
Would you be going to work on a bad day?
-
How many of each kind of day do you have in a month?
§319 Daily Activities
§319.1 Background
and General Description
1. Do you live in an apartment, a house, a duplex, a
condo, a mobile home?
-
does your house have one story or two?
-
is your bedroom upstairs or downstairs?
-
how many rooms?
2. What do you do on an average day?
3. Describe your day for us from the time you get up in
the morning until you go to bed at night.
4. Give us some examples of things you do differently
now than you used to do.
§319.2
Activities of Daily Living
How are the following things handled
at your house?
-
cooking
-
doing the dishes
-
grocery shopping
-
cleaning
—dusting
—straightening up
—taking out the garbage
—making beds
—changing bed sheets
—vacuuming
—floor mopping
—bathroom cleaning
—laundry
-
watching children
-
yard work
—grass cutting
—gardening
—snow shoveling
-
home repairs
-
paying bills/handling finances
-
going to the post office
-
taking public transportation
-
obtaining a telephone number from phone directory or directory assistance.
§319.3
Social Functioning and Leisure Activities
1. How often do you visit:
-
family members
-
friends
-
neighbors?
2. Do you initiate contacts or do they?
3. Do you have any problem getting along with:
-
family
-
friends
-
neighbors
-
store clerks
-
landlords
-
bus drivers?
4. How often do you go to church?
5. Do you participate in any organizations?
6. Do you play cards? Other games?
7. Do you attend sports events?
8. Do you go to movies?
9. Do you go out to eat?
10. Do you have any hobbies?
11. How often do you read the newspaper
12. Do you watch television news programs?
13. Do you keep up with current events?
§319.4
Personal Care
1. Do you have any problem, need any assistance or
reminders with:
-
dressing
-
buttoning clothes
-
tying shoelaces
-
bathing
-
combing/fixing hair
-
shaving
2. Do you get dressed every day?
§319.5
Examples of Limited Activities
1. How much time do you spend daily doing the following:
-
sitting in your favorite chair—describe the chair
-
watching television
-
reading
-
talking on the telephone
-
sleeping
-
lying down?
—Where do you go to lie down
(e.g., bed, couch, recliner)?
2. How often do you drive a car?
3. How often do you go out of the house?
4. When you begin a household task, do you complete it
in a timely manner? If not, give examples.
5. Are there any hobbies you have been forced to give up
because of your impairment?
Thomas E. Bush has devoted his practice to social security disability issues since 1977. He was elected to NOSSCR’s Board of Directors in 1988, and was President of NOSSCR for the 1997-98 term. He is the author of Social Security Disability Practice, from which this article is excerpted.
