DOES YOUR DOCTOR DECIDE IF YOU GET DISABILITY BENEFITS FROM SOCIAL SECURITY OR SSI?



Does Your Doctor Decide If You Get Disability Benefits from Social Security or SSI?



 
Social Security Disability involves much more than a medical opinion from your doctor. Social Security Disability determinations involve medical information, vocational information (regarding your jobs), as well as an individual's age, education, and residual functional capacity (what you are able to do despite the limitations of your disabling conditions).

Your doctor cannot determine if you are disabled because your doctor does not know A) the listing criteria established in the Social Security Disability handbook nor B) what vocational guidelines might affect your eligibility for Social Security Disability or SSI benefits. Your doctor may feel that you are disabled from your work activity based upon a medical opinion, but medical opinions do not always establish disability.

The Social Security definition of disability clearly states that the ability to perform substantial gainful work activity has to be considered no matter what an individual's disabling condition might be.



If you are still working full time, despite the fact that you have significant medical and/or mental problems, your disability claim is likely to be denied on the basis of work activity alone.

The definition of disability for Social Security Disability states that an individual must have an illness that is likely to result in death, or that they have been unable to work for twelve months, or that they are expected to be unable to work for twelve months due to a physical or mental impairment.

When Social Security makes a medical determination, they must consider all of the aforementioned factors, and, as you can see, some of the factors are not medical in nature. Which explains why your doctor cannot decide if you get disability.

However, your doctor can help your disability case by providing a treating physician's statement (a statement from the doctor who has a history of treating you; you may have more than one of these) that includes objective medical evidence (clinical notes, testing, etc), diagnosis, response to treatment, a prognosis, and what he or she feels that you are able to do including activities that are involved in a work setting.

This statement must be thorough and somewhat detailed in order to help your disability case. It is not enough to simply write that you are totally disabled and unable to work. Social Security Disability is based upon residual functional capacity rather than any certain medical or mental conditions. If your residual functional capacity is severely limited by your disabling condition or conditions, you may be approved for disability.


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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