Will my doctor charge me for a letter for my Social Security Disability claim?

Whether or not your doctor charges you for a letter or statement to help your disability claim...depends on the doctor.

There are some doctors who absolutely refuse to become involved in disability cases and others who will supply a statement in support of your claim, but only if you pay a fee. Some doctors charge hundreds of dollars--if you are a patient of one of these doctors, consider changing physicians before filing a disability claim, and certainly well in advance of a hearing before an administrative law judge.

Though no one wants to appear to be a doctor shopper, if your physician appears not to believe you are disabled, this will naturally provide the potential to hurt your chances of winning Social Security Disability or SSI benefits.

It's important to note that physician statements usually have little affect on your chances of winning a disability claim at the first two levels of consideration, the initial social security application and the reconsideration appeal. This is because the disability examiners in charge of deciding these claims, who are employed by the state disability determination services agency (DDS), typically make their decisions based on medical records and the opinion of the social security doctor assigned to their unit. There's a lot of pressure within DDS for examiners to keep the number of approvals down.

However, if you are scheduled for a disability hearing you should do everything in your power to get a statement from your physician in support of your claim, even if it takes several attempts to do so.

The statement should address your residual functional capacity (RFC), spelling out the physical and mental activities or tasks you can or cannot perform due to your impairment. Doctor's notes are usually not enough; they tend to include symptoms, diagnosis, record of medical treatment, and prognosis without going into detail about how the patient's ability to participate in substantial gainful activity (earning a living) is affected.

The physician statement does not have to be lengthy, but should be clear regarding residual functional capacity. In fact, there are boilerplate RFC forms that are nothing more than 5- to 8-page check-off forms. They take very little time to complete (about 15 minutes including the time it takes to pull your chart). If you have a disability attorney, the chances are that your attorney will have RFC forms on hand and he or she will probably attempt to get RFC forms completed by your doctor, or doctors, in preparation for a disability hearing.

ALJs (administrative law judges) usually pay more attention to physician RFC statements that help them to decide if a claimant can perform past work, some other work, or is unable to work enough to participate in substantial gainful activity; i.e., eligible for disability benefits.

In all candor, at the hearing level a supportive letter or statement from your physician can mean the difference between winning or losing a claim for SSD or SSI. If you are being represented by a disability attorney at your hearing and he or she has not requested such documentation from your physician, you might want to consider your representative about this. It's that important.

If you are representing yourself at your disability hearing (a bad idea for so many reasons) do not be like the other 90 percent of those who do not hire a disability lawyer and show up to your hearing without a residual functional capacity statement that bears the weight of your physician's opinion (as well as the weight of their signature as the M.D. who treats you).

There are some physicians who absolutely refuse to supply an RFC, be it on the request of a patient or a disability attorney. You can't know if your physician is one of those unless you ask. Although it may be awkward, if you are filing for SSD or SSI you should ask your physician this question as soon as possible. You have a much better chance of winning benefits if your physician is supportive of your claim, particularly if the physician has been treating you since your symptoms first began.

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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