Does my doctor decide if I am disabled?

Can my doctor get me my disability benefits?

There are more than a few individuals who have the idea that when Social Security decides to approve or deny a disability claim, this decision is based on a few words from their doctor. No, it doesn't work that way.

So, the simple answer to this question is no. Social Security uses its own criteria to establish if you are disabled. And while a disability examiner or a judge at a hearing is relying on information in a doctor's medical records (or a hospital or clinic's), a simple statement from a doctor will not suffice. Ultimately, what Social Security is looking for in medical records falls into one of two possible categories:

One: that you have a medical condition that meets the disability requirements of a listing in the SSA blue book.

Two: if you do not have a listing-level condition, that your condition makes it impossible to go back to your past work or do any other type of work, based on your age, limitations, education, and skills.

A claimant's doctor will never be in the position of deciding if someone gets disability benefits. Probably, 99 percent of all doctors have no real idea how Social Security even makes it decision.

However, while your doctor does not decide if you are disabled, their opinion can be useful to your disability claim. This is usually true at a disability hearing, of course. At a hearing, the decision maker is an administrative law judge and a disability representative, often a disability attorney, is typically involved and presents a case for approval. Integral to this is usually the submission of medical source statements (which are basically residual functional capacity forms) that have been gotten from an individual's doctor or doctors.

While some would say that disability examiners who work at the lower claim levels are trained to give weight to a treating physician's opinion provided their records support that opinion, the honest truth is that disability examiners (who work on disability applications and reconsideration hearings) do not give much credence to the opinions of treating physicians.

Even at a disability hearing, where a medical source statement from a doctor can help win a case, your doctor cannot simply write a statement saying you are disabled. It must be shown by the records and/or a doctor's statement, that you have specific physical and/or mental limitations that reduce the ability to do work activity.

They (your doctors) can, of course, complete a physician's statement, i.e. medical source statement, that includes a diagnosis, medical treatment, response to medical treatment and medications, prognosis, and their opinion as to the limitations imposed upon you by your disabling conditions.

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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