Version 2.77

Reference Information

Type Source Reference
Original Form Social Security Administration Original form upon which the LOINC panel is based. Mental residual functional capacity (RFC) assessment form

Panel Hierarchy

Details for each LOINC in Panel LHC-Forms

LOINC Name R/O/C Cardinality Example UCUM Units
46611-0 Mental residual functional capacity (RFC) assessment form
Indent45965-1 Name Set
IndentIndent45394-4 Patient Last (Family) name
IndentIndent45392-8 Patient First (Given) name
IndentIndent45393-6 Middle initial
IndentIndent45395-1 Patient Name suffix
Indent45396-9 Social Security number [Identifier]
Indent46635-9 Categories [RFC]
Indent46612-8 Summary conclusions Set
IndentIndent46613-6 Remembers locations and worklike procedures [RFC]
IndentIndent46614-4 Understands and remembers very short and simple instructions [RFC]
IndentIndent46615-1 Understands and remembers detailed instructions [RFC]
IndentIndent46616-9 Carries out very short and simple instructions [RFC]
IndentIndent46617-7 Carries out detailed instructions [RFC]
IndentIndent46618-5 Maintains attention and concentration for extended periods [RFC]
IndentIndent46619-3 Performs activities within a schedule, maintains regular attendance, is punctual within customary tolerances [RFC]
IndentIndent46620-1 Sustains an ordinary routine without special supervision [RFC]
IndentIndent46621-9 Works in coordination with or proximity to others without being distracted by them [RFC]
IndentIndent46622-7 Makes simple work-related decisions [RFC]
IndentIndent46623-5 Completes normal workday and week WO interruptions from psych symptoms and performs at consistent pace WO unreasonable number and length of rests [RFC]
IndentIndent46624-3 Interacts appropriately with the general public [RFC]
IndentIndent46625-0 Asks simple questions or request assistance [RFC]
IndentIndent46626-8 Accepts instructions and respond appropriately to criticism from supervisors [RFC]
IndentIndent46627-6 Gets along with coworkers or peers WO distracting them or exhibiting behavioral extremes [RFC]
IndentIndent46628-4 Maintains socially appropriate behavior and adheres to basic standards of neatness and cleanliness [RFC]
IndentIndent46629-2 Responds appropriately to changes in the work setting [RFC]
IndentIndent46630-0 Aware of normal hazards and take appropriate precautions [RFC]
IndentIndent46631-8 Travels in unfamiliar places or use public transportation [RFC]
IndentIndent46632-6 Sets realistic goals or make plans independently of others [RFC]
IndentIndent46633-4 Remarks [RFC]
Indent46634-2 Functional capacity assessment [RFC]
Indent30947-6 Date form completed {mm/dd/yyyy}

Fully-Specified Name

Mental residual functional capacity (RFC) assessment form

Basic Attributes

First Released
Version 2.19
Last Updated
Version 2.29
Order vs. Observation
Panel Type

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