Chronic Persistent Lung Infections
Residual Function Capacity Assessment for Chronic Persistent Lung Infections
What Is RFC?
When your chronic persistent lung infection 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.RFC is a claimant’s ability to perform work-related activities. In other words, it is what you can still do despite your limitations. An RFC 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 RFC, the less the Social Security Administration believes you can do.
Assessing Impairment Caused by Chronic Persistent Lung Infections
Even though listing 3.08 states that chronic persistent lung infections “are evaluated on the basis of the resulting limitations in pulmonary function,” the SSA acknowledges that factors not related to pulmonary function can justify a favorable disability determination if duration is satisfied or expected to be satisfied. This is a very important issue, because it is just the kind of situation where a SSA adjudicator might err in failing to consider factors other than the results of pulmonary function testing. In fact, SSA development of the medical evidence might fall short of even identifying other disabling factors, if attention is kept only on the pulmonary testing results. Some adjudicators place far too much weight on spirometric test results; such reliance on test values is proper only if other health factors contribute no additional limitation to exertional capacity. Furthermore, there can be a large difference between SSA policy and what an individual adjudicator might do out of ignorance, claim processing time pressures, laziness, or indifference.
If exertion results in increasing coughing and hemoptysis those facts should be taken into account on the RFC, even if the spirometry or other pulmonary testing evaluated in isolation suggests less limitation. If pulmonary function studies are available, such as spirometry, the SSA should base its determination not on the spirometric results alone but on the total clinical picture. The non-pulmonary parts of the impairment, to the extent they exist, must be taken into account in determining RFC. Such factors as malnutrition, anemia, hemoptysis, easy fatigability, cough, and underlying disease (such as diabetes mellitus) could result in a RFC much more favorable to you than pulmonary functions alone would suggest. In such claims, it would be extremely improper and negligent for the SSA adjudicator to refer to a decision only using pulmonary functions. In some cases, the results of spirometry or other pulmonary function tests may be the least basis for imposing limitations.