What is the Application Process for Social Security Disability and SSI?
How do you Win Benefits under Social Security Disability or SSI?
If I am determined disabled, how far back will Social Security pay benefits?
How do you prove your disability case if you have a mental condition?
What Can I Do to Improve My Chances of Winning Disability Benefits
Common Mistakes after Receiving a Denial of Social Security Disability or SSI Benefits
How to File for Disability - Tips for Filing
If You Get Approved For SSDI Will You Also Get Medicare?
How much does a Social Security disability attorney get paid?
Social Security Disability SSI Criteria and the Evaluation Process
How long does it take to be approved for SSI or Social Security disability?
What do you Need to Prove to Qualify for Disability Benefits?
Social Security Disability SSI and Fibromyalgia
Social Security Disability SSI and Degenerative Disc Disease
Can I Qualify For Disability and Receive Benefits based on Depression?
Answers to questions about SSD and SSI disability
What Disabilities Qualify for SSI and Social Security Disability Benefits?
Social Security Disability Status
Social Security Disability Tips — how a claim gets worked on
Social Security Disability, SSI Disability - Terms, Definitions, Concepts
Should you get a Statement from a Personal Physician for your SSD or SSI Disability Case?
How to prove you are disabled
and win disability benefits
A statement from a doctor can, in many social security disability and SSI cases, make the difference between winning or losing a claim. But not just any statement. As a disability examiner, I found it fairly routine to receive very brief signed statements from claimants' doctors that said little more than "My patient is completely disabled and unable to work".
This type of statement is extraordinarily useless to a disability examiner (who makes the decision on an application for disability or on a first appeal, a reconsideration) or a judge at a disability hearing. Why? Because the social security administration is very interested in receiving the opinion of a claimant's treating physician but only if it is specific enough to indicate why the physician believes that their patient is disabled and unable to work.
To satisfy SSA (the social security administration), a statement (known as a medical source statement or residual functional capacity, or RFC, statement) should be as follows:
1. It should indicate the claimant's diagnosed condition or conditions.
2. It should indicate the date of the diagnosis.
3. It should indicate the outlook, or prognosis, for the condition, or conditions.
4. Most importantly, it should indicate all the various ways in which the claimant is functionally limited and, consequently, has difficulty engaging in normal daily activities.
5. Finally, a doctor who submits a statement should be a treating physician, which is, according to the social security administration, a doctor who has an extended history of treating the claimant for their condition, as opposed to, for example, an urgent care doctor who has seen the claimant once or twice. As SSA sees it, a treating physician is qualified to give a valid opinion as to the claimant's medical condition and how the condition affects them.
Regarding item number 4, it is usually more effective and efficient for a doctor to simply complete a check-off style form that allows them to address the claimant's physical strength level, their range of motion, their postural or ambulatory limitations (walking, bending, crouching, balancing), their deficits with regard to their senses (seeing, hearing, feeling), and any other physical functional short-comings they may have. If the claimant's condition is mental, the physician or psychologist should indicate which cognitive deficits they have. For example, do they have trouble retaining information, learning information, concentrating, getting along with supervisors or co-workers, etc.
Statements that obtain this type of detailed information are not, however, sent to a claimant's doctor or doctors by social security. When a case is being processed, they are completed (in the form of something known as a RFC form) by the doctors who act as consultants to disability examiners.
Wouldn't it make sense for social security to simply send a form to a claimant's own doctor to get their detailed opinion, especially in the format that they prefer (a check-off style form)? Yes, it would. But SSA does not do this, and it may be because it is a cost issue.
However, a competent and skilled disability attorney will nearly always try to obtain a statement from the claimant's treating physician, or physicians if they have more than one. And this is because such statements can often turn the tide in a case and effectively win disability benefits. Why are these statements effective with administrative law judges at disability hearings? Because an ALJ will typically recognize that the claimant's treating physician has an opinion that should carry weight in the decisional outcome of a case.
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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