Published May, 2008
Physical Residual Functional Capacity Questionnaire (2008)
This questionnaire, provided by attorney Leslie Kline-Capelle, formerly of Health Advocates, is intended to assist with a determination of disability for purposes of obtaining social security disability benefits. In order to be effective, the form must be completed by a medical doctor who is treating the individual applying for benefits. Although not HIV/AIDS specific, the form, if properly completed, may be a helpful piece of evidence in a case being heard by an administrative law judge (ALJ).
Copyright Information: CHLP encourages the broad use and sharing of resources. Please credit CHLP when using these materials or their content. and do not alter, adapt or present as your work without prior permission from CHLP.
Legal Disclaimer: CHLP makes an effort to ensure legal information is correct and current, but the law is regularly changing, and the accuracy of the information provided cannot be guaranteed. The legal information in a given resource may not be applicable to all situations and is not—and should not be relied upon—as a substitute for legal advice.