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Should you get a Statement from a Personal Physician for your SSD or SSI Disability Case?

A statement from a doctor can, in many social security disability and SSI cases, make the difference between winning or losing a disability claim. But not just any statement. As a disability examiner, I found it fairly routine to receive very brief signed statements from claimants' doctors that said little more than "My patient is completely disabled and unable to work".

This type of statement is extraordinarily useless to a disability examiner (who makes the decision on an application for disability or on a first appeal, a reconsideration) or a judge at a disability hearing.

Why? Because the social security administration is very interested in receiving the opinion of a claimant's treating physician but only if it is specific enough to indicate why the physician believes that their patient is disabled and unable to work.

To satisfy SSA (the social security administration), a statement (known as a medical source statement or residual functional capacity, or RFC, statement) should be as follows:

1. It should indicate the claimant's diagnosed condition or conditions.

2. It should indicate the date of the diagnosis.

3. It should indicate the outlook, or prognosis, for the condition, or conditions.

4. Most importantly, it should indicate all the various ways in which the claimant is functionally limited and, consequently, has difficulty engaging in normal daily activities.

5. Finally, a doctor who submits a statement should be a treating physician, which is, according to the social security administration, a doctor who has an extended history of treating the claimant for their condition, as opposed to, for example, an urgent care doctor who has seen the claimant once or twice. As SSA sees it, a treating physician is qualified to give a valid opinion as to the claimant's medical condition and how the condition affects them.

Regarding item number 4, it is usually more effective and efficient for a doctor to simply complete a check-off style form that allows them to address the claimant's physical strength level, their range of motion, their postural or ambulatory limitations (walking, bending, crouching, balancing), their deficits with regard to their senses (seeing, hearing, feeling), and any other physical functional short-comings they may have.

If the claimant's condition is mental, the physician or psychologist should indicate which cognitive deficits they have. For example, do they have trouble retaining information, learning information, concentrating, getting along with supervisors or co-workers, etc.

Statements that obtain this type of detailed information are not, however, sent to a claimant's doctor or doctors by social security. When a case is being processed, they are completed (in the form of something known as a RFC form) by the doctors who act as consultants to disability examiners.

Wouldn't it make sense for social security to simply send a form to a claimant's own doctor to get their detailed opinion, especially in the format that they prefer (a check-off style form)? Yes, it would. But SSA does not do this, and it may be because it is a cost issue.

However, a competent and skilled disability attorney will nearly always try to obtain a statement from the claimant's treating physician, or physicians if they have more than one. And this is because such statements can often turn the tide in a case and effectively win disability benefits. Why are these statements effective with administrative law judges at disability hearings? Because an ALJ will typically recognize that the claimant's treating physician has an opinion that should carry weight in the decisional outcome of a case.

Medical Source statement PDF download

  • What medical conditions will get you approved for disability?

  • What kind of Mental Problems Qualify for Disability?

  • Which conditions will social security recognize as a disability?

  • Tips for getting Social Security Disability or SSI benefits approved

  • SSDRC Homepage:

    Social Security Disability and SSI Resource Center

    The Most Basic questions about Getting Disability Benefits

    Social Security Disability SSI and whether or not you can work

    Common Mistakes to avoid after being denied for Disability

    Social Security Disability SSI Questions and Answers

    More Social Security Disability SSI Questions and Answers

    Common Questions about Social Security Disability and SSI

    Winning Social Security Disability or SSI Benefits

    The SSI Disability Benefits Program

    Medical exams for disability claims

    Applying for Disability in various states

    Social Security Disability SSI and Doctors - Yours and Theirs

    Social Security Disability and SSI Claim Reviews

    Social Security Disability SSI System and Benefits for Children

    Denials, Appeals, and Getting a Disability Lawyer or Representative

    What you should know about Social Security Disability and SSI Denials

    Questions about Disability Lawyers and Hiring a Disability Attorney

    Frequently asked questions about getting Denied for Disability Benefits

    FAQ on Disability Claim Representation

    Disability hearings before Judges

    Selecting and hiring Disability Lawyers

    Various Types of Benefits including SSI, Mental, and Child benefits

    Social Security and SSI based on Mental Disability

    Social Security Disability or SSI Benefits for Children

    Disability Benefits through Social Security

    Filing for Social Security Disability or SSI Benefits

    Social Security Disability SSI: Medical Evidence and Records

    Filing your claim for disability benefits

    Eligibility for receiving disability benefits

    Info about Social Security Disability Approvals and Being Approved

    FAQ on Social Security Disability SSI decisions

    The SSD SSI Decision Process and what gets taken into consideration

    Resources on this site

    Social Security Disability, SSI Terms and Definitions

    Previously answered questions regarding SSD and SSI

    For Individuals living in North Carolina

    Applying for Disability in North Carolina

    North Carolina Disability Lawyer

    Related pages:

    A "proper" statement from your doctor can have a dramatic effect on your disability case
    Should you get a Statement from a Personal Physician for your SSD or SSI Disability Case?
    Will my doctor charge me for a letter for my social security disability claim?
    Will Social Security Attempt To Get A Letter From Your Doctor To Help Your Case?
    Letters from doctors for Social Security Disability
    Social Security Disability Doctor, Supportive Statements
    Can I file a disability claim for my adult child who lacks mental capacity?
    Can I get disability if I have seizures?

    These pages answer some of the most basic questions for individuals who are considering filing a claim.

    Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
    How to Apply for Disability - What medical conditions can you apply and qualify for?
    Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
    What happens if I file a disability application and it is denied by a disability examiner or Judge?
    How to Prove you are disabled and qualify to win disability benefits
    How do you prove your disability case if you have a mental condition or impairment?
    Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
    Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria