Social Security Disability Medical Evaluation Form, Can A Doctor Be Forced to Complete One?

Social Security Disability examiners and Administrative Law Judges have to have relevant medical evidence (i.e. licensed or certified physicians, psychiatrists, psychologists, speech pathologists, etc.) to make their disability determinations.

The Social Security administration does pay medical providers (hospitals, doctor's offices) a fee for copying the records but providing medical evidence for Social Security is strictly voluntary. Social Security can only request medical evidence from an individual's treating physicians; they cannot demand any kind of medical evidence from a medical provider.

Sometimes, disability applicants who appeal their disability denial need to have a medical evaluation form completed by their treating physician to improve their chances of being approved for disability benefits. Very often, their Social Security representative (a disability lawyer or a non-attorney representative) will try to obtain a medical evaluation from known as a physical residual functional capacity form, or a mental residual functional capacity form, in order to present an individual's disability claim more favorably to an Administrative Law Judge at an SSA hearing office.

Social Security does give weight to medical statements, or disability forms, if they give a diagnosis, prognosis, objective medical information, response to treatment, and an opinion as to a patient's ability to work at a substantial gainful activity level (SGA is a monthly earnings amount that Social Security considers to be self supporting). For this reason, getting a medical disability evaluation form from a doctor can be a great help to a disability claim.

Unfortunately, it is often difficult to get the doctor to complete a disability medical evaluation form or submit a written statement even if they have treated the disability applicant for years.

Sometimes, they refuse on the grounds that they do not have time to complete the paperwork, or they charge a high fee to complete them. Since there is no way for Social Security to force doctors or medical professionals to complete such forms, it is strictly up to the individual's doctor as to what they are willing to do to help their patient win benefits from Social Security.

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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