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How does a Medical Source Statement (RFC Form) help win a Social Security Disability or SSI Claim?How to prove you are disabled and win disability benefits A medical source statement is a statement supplied by a physician regarding an individual's medical condition. The statement generally includes a diagnosis of the condition, or conditions, as well as the various functional capabilities and functional deficits possessed by the person. A medical source statement is essentially synonymous with the RFC, or residual functional capacity, form used by the social security administration to rate a claimant's remaining, or residual, functional capabilities. SSA uses both physical and mental RFC assessments to make decisions on cases and RFC forms are completed by disability examiners who make decisions on SSD claims and SSI claims. RFC assessments are also made by the medical consultants (M.D.s) and Psychological consultants (Ph.D. level psychologists) who assist disability examiners in their decision-making process. How is a medical source statement different from an RFC form and assessment? An RFC form and a medical source statement may look practically identical as they are usually multi-page check off lists that ask a claimant's doctor to rate the claimant in specific functional areas such as their ability to stand and sit for certain lengths of time, the distance they are able to walk, their ability to reach, their ability to bend, squat, kneel, and so forth. In fact, for all intents and purposes, they are exactly the same thing. The only real difference between an RFC form and a medical source statement is the following: A) An RFC form is used by a disability examiner to rate a claimant's functionally abilities and is supported by the opinion of a medical consultant who is part of the disability examiner's case processing unit (in other words, a medical doctor whose job is simply to read the medical records of claimants and issue an opinion as to their capabilities though he has never met nor treated them). B) A medical source statement is typically obtained to present to an ALJ--administrative law judge--at a disability hearing. In the vast majority of cases, a medical source statement has been obtained by the claimant's disability attorney or non-attorney disability representative. How does the representative or attorney obtain the statement? In the same way that medical records are obtained, by sending a written request to the claimant's treating physician. Will a treating physician usually comply with the request to provide a statement? Most will; however, some doctors will state that they do not have time to fill out the form (which usually requires 10-15 minutes). Some doctors, though they are in the minority, will also attempt to charge for the completion of a form. Working in disability claim representation, I myself have seen doctors attempt to charge up to five hundred dollars for completing a medical source statement form. If the doctor states that he will not complete the form without being paid, will a disability attorney or disability representative decide that the form is still worth getting? In many cases, yes. This is because a medical source statement can very often provide crucial evidence that strongly supports "a finding of disabled" from a federal administrative law judge. While disability examiners at the level of an application for disability or the first disability appeal (the reconsideration request) will very often ignore a statement from a claimant's treating physician, or not give it the consideration it deserves, judges at hearings almost universally give such statements full consideration and considerable weight as long as the doctor's statement is in sync with their own history of providing treatment to the claimant. In other words, medical source statements are often instrumental in winning cases at disability hearings. This, of course, brings up the inevitable question of who will pay the doctor for the statment. Inevitably, the claimant will be the one who pays for the statement, though many attorneys and representatives will "advance for costs" (such as for obtaining medical records and physician statements) meaning that they will pay the doctor and then have the claimant reimburse when the case is concluded and, hopefully, won. 
Return to: SSDRC, or the Questions, Answers, Tips, and Advice page Topics and Questions SSD and SSI are Federal Programs The title II Social Security Disability and title 16 SSI Disability programs operate under federal guidelines and, therefore, the program requirements--medical and non-medical--apply to all states: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming Recent approval and denial statistics for various states can be viewed here: Social Security Disability, SSI Approval and Denial Statistics by state Special Section: Disability Lawyers and unnecessary claim denials |