Medical Evidence for Social Security Disability

Every decision in Social Security Disability (SSD) and SSI matters is based on a claimant’s medical records, and what they say about his or her ability to work (or not). Because medical records are critical to the outcome of disability cases, some applicants make the mistake of sending in far too much information in an effort to bolster their claims. This is not at all helpful, because it makes the disability examiner or judge’s job that much harder—sifting through a pile of records looking for acceptable medical evidence is both frustrating and time-consuming, when the ideal here is for the claimant to be as helpful as possible in providing a picture of his impairment and functional limitations.

Of course, some if not most people filing for disability don’t really know what types of medical documentation Social Security is looking for, so they figure they’ll throw in everything but the kitchen sink to be on the safe side, unaware that they are wasting everyone’s time and probably delaying a decision in their case.

When submitting medical records for a disability examiner or judge to review, it’s best to send in only medical records signed by a physician or psychologist. Medical opinions from nurses, chiropractors, acupuncturists, homeopaths, etc., are not considered acceptable medical evidence. X-ray films or other test results are not useful unless they are accompanied by a report and an interpretation—disability examiners and judges are not physicians, and do not know how to read these tests.

Pharmacy printouts are also not helpful—any medications you are taking should be covered in the notes or records from the treating physician or physicians.

So what kinds of medical records are useful? Admission or discharge summaries from hospitals, physician notes, X-rays, MRIs, or other test results that are accompanied by interpretive reports are all very useful to those making disability decisions.

Keep in mind that the point of submitting medical evidence is to help prove that A) you have a severe impairment and B) this impairment limits your functional capacity to the point that you are no longer able to earn a living wage. In order to prove these points you must have a written opinion from a physician or other approved medical treatment source that offers details about your symptoms and how they limit your ability to function. This should include how an impairment affects normal daily living activities, such as standing, lifting, walking, concentration, memory, etc., as well as a prognosis (how the medical condition is expected to progress over time).


For information on Social Security Disability, visit the

Social Security Disability Benefits Resource Center

Requesting a Disability Hearing After You are Denied

If you receive an initial Social Security or Supplemental Security Income disability denial, can you file immediately for your disability hearing with an administrative law judge? Unfortunately, no you must begin what is known as the Social Security disability appeal process and it can be a very time consuming arduous journey for disability applicants.

So how does the appeal process work? Well, if your initial claim is denied you begin with the request for reconsideration appeal. Reconsideration appeals generally take thirty to sixty days to receive a disability decision and are for the most the medical decision will be a denial as only about 15 percent of reconsideration appeals are approved. If your reconsideration appeal is denied what can you do? You should keep the disability appeal process moving toward the administrative law judge hearing, where you have the best chance of being awarded Social Security disability benefits. In fact, about two thirds of all disability applicants are awarded disability benefits at an administrative law judge hearing.

Regrettably, you may be waiting along time for your disability benefits if you have to avail yourself of the Social Security appeals process. Average wait times for disability hearings across the nation are months or even years. Social Security is working on reducing this workload, but with more disability applications being file than ever in the past, Social Security is struggling to reduce this workload.

In conclusion, you cannot request and immediate hearing if your claim has been denied. If you plan on winning your disability benefits you will most likely have to avail yourself of the disability appeal process including the administrative law judge hearing to win your disability benefits.



For information on Social Security Disability, visit the

Social Security Disability Benefits Resource Center

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.


For information on Social Security Disability, visit the

Social Security Disability Benefits Resource Center