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How to file for disability, Filing for SSI
Disability Requirements, Disability Status
How long is the wait?, Disability Application
The Social Security List of Impairments
Qualifying for Disability, Mental Disability
Disability Lawyer Info, Disability Back Pay

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.








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These pages provide answers to basic questions about pursuing disability benefits

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For the sake of clarity, SSDRC.com is not the Social Security Administration, nor is it associated or affiliated with SSA. This site is a personal, private website that is published, edited, and maintained by former caseworker and former disability claims examiner, Tim Moore, who was interviewed by the New York Times on the topic of Social Security Disability and SSI benefits in an article entitled "The Disability Mess" and also by the Los Angeles Times on the subject of political attempts to weaken the Social Security Disability system.

The goal of the site is to provide information about how Social Security Disability and SSI work, the idea being that qualified information may help claimants pursue their claims and appeals, potentially avoiding time-consuming mistakes. If you find the information on this site helpful and believe it would be helpful to others, feel free to share links to its homepage or other pages on website resource pages, blogs, or social media. Copying of this material, however, is prohibited.

To learn more about the author, please visit the SSDRC.com homepage and view the "about this site" link near the bottom of the page.