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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








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

Can you get temporary Social Security Disability or SSI benefits?

Permanent Social Security Disability

What is the difference between Social Security Disability and SSI?

Who is eligible for SSI disability?

Can I Be Eligible For SSI And Social Security Disability At The Same Time?

What makes a person eligible to receive disability benefits?

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?









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.