Social Security Disability SSI and Proving you are Disabled

Here's a scenario with which I am very familiar. A claimant decides to file for disability, gets denied, and then says something to the effect of "I don't understand why I was denied. My doctor wrote a statement on my behalf."

From my own experience as a former Social Security Disability claims examiner and also in the area of disability claim representation, I can state the following:.

1. Claims that are decided at the disability application and reconsideration level may or may not benefit from a statement provided by one's doctor or treating physician. Why is this? The answer is complex and may vary from one state disability processing agency to another (these agencies make disability decisions for the social security administration and are usually referred to as DDS, or disability determination services).

However, in short, disability examiners are not typically compelled to give great weight or controlling weight to statements provided by physicians.

As a disability examiner working on cases, I found it to be the unfortunate case that, on occasion, a statement provided by a physician would be completely ignored. The illogic of this was stupendous since it meant, by definition, that the opinion provided by the disability examiner's unit medical consultant (a doctor who works in the same processing unit as the examiner) would trump the opinion of the claimant's actual doctor.

Mind you, the unit medical consultant (a good way to think of this title is to replace it with "social security doctor") had never once seen the claimant, and had never once treated the claimant. Yet, he was still basing his final opinion on the records provided by the claimant's physician.

2. Claims that are decided at the Social Security Disability hearing level, benefit greatly from the stated opinion of a claimant's doctor or treating physician. In fact, such a statement, known as a medical source statement or residual functional capacity statement has been known to handily win a disability case.

What these observations mean is this: proving you are disabled for the purpose of obtaining Social Security Disability benefits or SSI disability benefits may be harder at the initial claim level and at the request for reconsideration level (the majority of all initial claims and the vast majority of all reconsiderations are, in fact, denied).

And a detailed statement from your doctor may not be of much benefit at these lower levels (though, that's not to say this is always the case--if your doctor is willing to provide a statement at the lower levels and another at the hearing level, by all means, take advantage of this). However, you should always attempt to gain such a statement from your physician, particularly if your case is scheduled to be heard at a hearing.

Detailed documentation, documentation that cites your functional limitations and diminished ability to work and is provided in a statement by your physician can make the difference in a case. Just keep in mind that such statements tend to deliver the biggest bang for the buck at a hearing, not at the initial claim and reconsideration appeal levels.

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.

Most popular topics on

Social Security Disability in North Carolina

Common Mistakes to avoid after being denied for Disability

Tips to Prepare for Filing for Social Security Disability or SSI

Advice to Win SSD and SSI Benefit Claims

Social Security Disability SSI Questions

What is the difference between Social Security Disability and SSI?

How to get disability for depression

Getting disability for fibromyalgia

SSI disability for children with ADHD

What is the Application Process for Social Security Disability and SSI?

Social Security Disability SSI Exam tips

More Social Security Disability SSI Questions

What makes you eligible for Social Security Disability or SSI?

Related pages:

After you file disability forms
How are Are Social Security And Social Security Disability different?
Doing the next disability appeal
The amount of back pay that you receive
Financial advice while waiting for disability to be approved
Applying for Social Security Disability with Cushing's syndrome
Where do I call to learn what is happening on my Disability Claim?
If You Get Social Security Disability or SSI, Will Your Dependents Get A Check?
How to file for disability, tips to start
How to file for disability in Michigan
Filing for disability with MS, multiple Sclerosis
Questions asked at a Social Security Disability or SSI hearing?
How to file for disability in California
What makes you eligible for Social Security Disability or SSI?
Filing for disability with scoliosis