RFCs used to determine who gets benefits are invasive and ableist

B. The “Grids” and Disability by Algorithm As noted earlier, the second way (in addition to the “listings” approach) to qualify for disability is by demonstrating a qualifying reduced “residual functional capacity.”75 The RFC process requires a complex evaluation of a claimant’s age, educational level, and other factors in determining whether a claimant can return to other jobs. While the process requires the same basic evidence as the “listings” approach—submission of medical information, work history data, etc.—the formula for determining eligibility is more convoluted. Yet it is ultimately an algorithmic decision—using the same inflexible bright-line approach as the listings. In this way the grids are a misguided attempt to incorporate social model of disability-related ideas into the SSA system. To make the decision of who will receive thousands of dollars in benefits each year and who will not, the SSA relies on “Grids,” a set of tables created by the SSA.76 These tables contain the following columns: “Rule,” “Age,” “Education,” “Previous work experience,” and “Decision.”77 These tables provide a deterministic approach to justice: the ALJ merely decides which “box” a claimant falls into and makes the decision accordingly. For instance, Rule 202.10 describes a claimant with the following profile: age defined as “closely approaching advanced age” (considered to be ages 50-54); education defined as “limited or less—at least literate and able to communicate in English;” and previous work experience defined as “unskilled or none.”78 Under these circumstances, an ALJ is instructed to find the claimant “not disabled.” There is no room for negotiation, case law, or other arguments: the claimant is simply determined “not disabled” as a matter of law.79 This rigid approach is combined with broad discretion for ALJs hearing appeals, who have authority to weigh hearing evidence. Under either the “listings” or RFC approach, the ALJ retains broad discretion to disregard a worker’s own treating physician—especially with the elimination of the “treating physician” rule in March 2017.80 For instance, a worker may submit a letter or evaluation written by her own primary care physician supportive of a finding of disability. An ALJ may view this letter with skepticism, given that a long-term patient-physician relationship means the doctor may have an incentive to exaggerate a patient’s disability. However, presuming the competency and agency of people with disabilities, the doctor may simply be responding to the patient’s own, deliberate exaggeration. Exaggerating or “masquerading” one’s disability has been conceptualized in the disability community as a way to reclaim a stigmatized turn of phrase. For comparison, there has been similar discussion of the decision by some members of the LGBTQ community to reclaim “queen,” “queer,” “dyke,” and other words.81 Some disabled people seek to continue this movement by making use of a cane, walker, or other stigmatized device, into a point of pride that can be strategically used to push against ableist systems, structures, laws, and policies.82 Masquerading disability allows people to claim their identity and agency—even in systems that require that they pass as nondisabled in order to be positioned as fully human (and in this case, fully employable.)83 Just as the determinism of the “Grids” works against claimants, so too does the procedural complexity of appeal hearings. The evidentiary record in a case routinely spans several hundred pages of medical records. These documents may include inscrutable hand-written doctors’ notes, medical jargon, private details from surgeries, and therapist notes. However, the ALJ has no duty to explain the evidence in simple terms to the claimant. While the judge is expected to make a decision on the basis of all the medically appropriate evidence before her or him, there is also no duty of the judge to develop the record beyond what is present. The hearing process can involve supposedly impartial expert testimony from “vocational experts” or “medical experts,” whom the judges work with frequently but whom the claimant almost surely does not know.84 In some senses, these “experts” may work to mitigate the alleged improper influence of a patient’s primary care physician discussed above.85