Medical Source Statement for Social Security Disability or SSI
Medical source statements can be helpful to an individual's disability claim if they contain the evidence SSA needs. Medical source statements should include:
1. Diagnosis
2. Clinical results (i.e. mental or physical exam results)
3. Prescribed treatment with a prognosis and response to treatment statement
4. Lab findings (i.e. blood work, blood pressure, MRI testing, x-rays, etc.)
Lastly, it is invaluable to
If you have a mental impairment your psychiatrist or mental health professional should include a statement as to your ability to understand instructions, remember and carry out those instructions, and your ability to appropriately respond to coworkers, supervisors, and work pressures in a work setting.
If you are filing for disability for a child, the physician should include a description of your child's functional limitations with regard to motor function, learning, communication, socializing, completing tasks, and self-care activities. If you child is an infant age birth to age 1, the statement should describe their response to stimuli.
Also see: How does a Medical Source Statement (RFC Form) help win a Social Security Disability or SSI Claim?
Medical Source statement PDF download
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability
Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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