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Social Security Disability Doctor, Supportive Statements

Most applicants who file for Social Security Disability (SSD) or SSI do so as a last resort—they simply are unable to earn a living due to their physical or mental condition. In many cases their treating physician, the one who is in the best position to evaluate their functional limitations and to give a prognosis (how the impairment will progress over time) agrees that the medical condition is both severe and disabling. Yet, how much weight does one’s treating physician carry in the disability determination process? Sadly, at least at the first two levels of consideration, not enough.

Decisions on initial disability applications and first appeals (requests for reconsideration) are decided by disability examiners who work for the state Disability Determination Services (DDS) agency. These examiners are under an enormous amount of pressure to keep their total number of approvals down; they give little consideration to reports from treating physicians because the reports typically support the case for disability.

DDS examiners are subject to “quality control” reviews, and if they hand out too many approvals they will probably find themselves out of a job.

However, supportive statements from treating physicians can be very important to claimants who file a second appeal. The second appeal is decided at a disability hearing by a federal administrative law judge (ALJ), who is not employed by DDS, and thus is not subject to the same pressure to deny disability claims. Perhaps because they do not feel the same pressure to deny claims, disability judges tend to give great weight to the opinions of claimants’ treating physicians, and are statistically far more likely to approve SSD/SSI claims than disability examiners: about half of all disability claims denied by DDS are later approved by an ALJ at the hearing level.

So, having a supportive opinion from a doctor can make or break a disability case if it has reached the hearing level, though the exact same opinion will have little if any impact on the decision of a disability examiner.

This is no accident: the entire disability determination process is designed to frustrate and discourage applicants, and the strategy works. Most individuals who are denied disability benefits do not appeal, or at least do not appeal to the hearing level, at which they stand their best chance of winning.

Claimants with severe mental or physical medical conditions who have the support of their treating physicians are in a good position to win Social Security disability benefits—if they have the stamina to see their claims through to the second level of appeal, a disability hearing before a judge.

Return to:  Social Security Disability Resource Center, or read answers to Questions

Related pages:

A "proper" statement from your doctor can have a dramatic effect on your disability case
Should you get a Statement from a Personal Physician for your SSD or SSI Disability Case?
Will my doctor charge me for a letter for my social security disability claim?
Will Social Security Attempt To Get A Letter From Your Doctor To Help Your Case?
Letters from doctors for Social Security Disability
Social Security Disability Doctor, Supportive Statements

Information on the following topics can be found here: Social Security Disability Questions and in these subsections:

Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI

These pages answer some of the most basic questions for individuals who are considering filing a claim.

Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
How to Apply for Disability - What medical conditions can you apply and qualify for?
Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
What happens if I file a disability application and it is denied by a disability examiner or Judge?
How to Prove you are disabled and qualify to win disability benefits
How do you prove your disability case if you have a mental condition or impairment?
Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria