Residual Functional Capacity Assessment for Epilepsy
What Is RFC?
When your epilepsy 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 Epilepsy
All epilepsy in which seizures cause a loss of consciousness or significant alteration in awareness, whether or not falling is involved, should receive certain basic environmental limitations:
- no work at unprotected heights;
- no driving; and
- no work around hazardous machinery where the claimant or others might be injured.
In juvenile myoclonic epilepsy, or other epilepsy in which photosensitivity has been established, exposure to flashing lights should be avoided. Pseudoseizures do not warrant any type of RFC limitation. Although these episodes supposedly arise from an emotional distress beyond the person’s control, the reality is that no one puts themselves in a lethal situation because of pseudoseizures. They do not occur when a person is driving or standing on the edge of a cliff. Alcoholic withdrawal seizures or non-epileptic (transient) seizures do not warrant RFC restrictions.
Most doctors would not consider a person safe to drive or perform similarly hazardous activities unless they have been seizure-free for at least 12 months. The SSA should provide environmental limitations for that amount of time since the last significant seizure as described above. To provide such limitations requires a RFC, and any RFC is an implicit admission by the SSA that the claimant has a significant, work-related impairment. The adjudicative significance of this statement cannot be overstated, because adults with sub-average intellectual deficits make up a large group of individuals who have epilepsy. There are several listings, especially listing 12.05 (see How to Get Disability Benefits for Mental Retardation by Meeting a Listing), in which IQ scores in the 60–70 range meet a listing when combined with another significant, work-related impairment. Also, even when no listing is met or equaled and the claimant has no intellectual deficit, seizure restrictions for epilepsy—especially when combined with other impairments—can influence a medical-vocational determination of disability.
Go back to About Epilepsy and Disability.