Residual Functional Capacity Evaluation - Delaware Disability (Page 3 of 3) in pdf

PLEASE REVIEW THE FOLLOWING BEFORE ANSWERING QUESTION 17:

SEDENTARY WORK. The regulations define sedentary work as involving lifting no more than 10 pounds at a time and

occasionally lifting or carrying articles like docket files, ledgers, and small tools. Although sitting is involved, a certain amount

of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are required

occasionally and other sedentary criteria are met. By its very nature, work performed primarily in a seated position entails no

significant stooping. Most unskilled sedentary jobs require good use of the hands and fingers for repetitive hand-finger actions.

“OCCASIONALLY” means occurring from very little up to one-third of the time. Since being on one’s feet is required

“occasionally” at the sedentary level of exertion, periods of standing or walking should generally total no more than about 2

hours of an 8-hour workday, and sitting should generally total approximately 6 hours of an 8-hour workday. Work processes in

specific jobs will dictate how often and how long a person will need to be on his or her feet to obtain or return small articles.

SSR 96-9p indicates that to perform substantially all of the exertional requirements of most sedentary jobs, a person would

not need to crouch, but would need to be able to occasionally stoop (bend the body downward and forward by bending the spine at

the waist).

17. Considering your patient’s medical history; clinical findings; diagnosis; response to treatment, and your

responses to this questionnaire, in your opinion, is your patient capable of performing SEDENTARY work on a

regular and continuing basis (i.e., 40 hours per week)

 YES  NO

If NO, 1) please explain why and when your patient became unable to perform SEDENTARY work 40 hours per

week? ____________________________________________________________

__________________________________________________________________________

2) can your patient do sedentary work as described above on a part-time basis?  YES  NO

If YES, how many hours per week could your patient perform on a consistent basis? _________

18. Identify any objective tests that support your conclusions: MRI

EMG

X-RAY CT SCAN EKG

EEG

Comments: ____________________________________________________________________________

Physician’s Signature ____________________________________________

Date ___________________

Physician’s Printed Name _____________________________________________________________________

Definitions

Mild: A limitation which causes an individual to lose approximately 0 – 30 minutes of productivity in an 8 hour workday.

Moderate: A limitation which causes an individual to lose approximately 31 – 90 minutes of productivity in an 8 hour

workday.

Severe: A limitation which causes an individual to lose more than 90 minutes of productivity in an 8 hour workday.

Linarducci & Butler, PA – RFC

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