How to get Approved for Disability on the Basis of a Back Condition

It is certainly possible to receive disability benefits on the basis of a back condition. However, back conditions must be evaluated on the basis of both medical and vocational information. And the degree to which functional limitations exist in a person are often hard to extrapolate simply based on the records provided by a claimant's treating physician.

This is, to some extent, why so many Social Security Disability and SSI disability claims filed primarily on the basis of a back condition are denied. Such claims would be strengthened if the social security administration's approach to deciding claims involved getting medical source statements from a claimant's own doctor, or doctors, in addition to requesting the medical records.

However, this is not done. Typically, medical source statements from a doctor are only used at a social security hearing, and only after a claimant's disability lawyer has A) requested that the doctor complete the form and B) has sent the form to the doctor's office to complete and return.

Will most doctor's complete this form on behalf of their patient? Most will; however, speaking also as someone who has been involved in the representation of disability claimant's (in addition to being a former disability examiner for social security), it is also true that some doctors will completely refuse to take the time to complete the form and some doctors will only complete the form if they are highly compensated (sometimes charging $200 or more to take the ten minutes needed to fill out the form).

Even when a claimant's treating physician is willing to complete the form (known as a medical source statement, or RFC--rfc stands for residual functional capacity--form) at no additional charge to the claimant, they may only get the form completed after numerous followup calls have been made by the disability attorney who is preparing the case for an upcoming hearing.

Note: Individuals who are considering obtaining a statement from their physician to support their case should probably wait until their case progresses to the disability hearing level. At the disability hearing, an ALJ, or administrative law judge, will be likely to give consideration to the opinion of a treating physician and assign some weight to it. At DDS, the disability examiner is far less likely to give weight to the doctor's opinion, and may even disregard it completely.

Why the difference? In actuality, there should be no difference since the system is federal and, therefore, should be uniform throughout (meaning the decision-making process should not be different at different levels of the system).

However, at the first two levels where decisions are handed out by disability examiners, the process is purely administrative. At the hearing level, the process becomes both administrative and legal (judges pay attention to case law and precedent, while disability examiners simply follow the lead of their managers who set policy in their case processing units and in their respective state agency).

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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