Medical records are necessary to prepare your Social Security Disability claim. But they are not enough to win in many disability cases – unless you are 55 or older. An extensive disability letter from your treating doctors is often critical proof that you need.
Presenting medical opinion evidence from your treating physicians is often more important than submitting medical records. Your treating health care providers’ opinions are essential to persuading many administrative law judges (ALJs) that you are disabled. Some ALJs ask what attending physician statements you have before taking testimony at the hearing.
This article has two purposes.
First, explain why you should ask your doctor to complete a disability letter or an attending physician’s statement or give their opinion in another format and what your doctor should discuss.
Second, explain to doctors how they can help their patients get approved for Social Security Disability benefits.
Many of the recommendations discussed in this article apply to workers compensation, long-term disability, and even car accident cases. The task of explaining the litigation process and burden of proof to treating doctors, the development and gathering of evidence, and the presentation of attending physician reports to the claim adjuster, judge, and jury are common in all tort claims based on personal injuries.
If you have questions about applying for disability, appealing the Social Security Administration’s (SSA’s) denial, or presenting your case at a disability hearing before an ALJ, call me for a free consultation: (804) 251-1620 or (757) 810-5614. See why my colleagues and former clients have voted me one of the best disability lawyers in Virginia.
Yes.
Your treating medical providers (surgeons, doctors, nurse practitioners, psychologists, counselors, etc.) can write letters explaining your disability status and restrictions and limitations.
No federal or state law or regulation prevents your treating physicians from writing letters or otherwise giving opinions stating you are disabled and explaining why.
Some health care providers have policies stating that doctors should complete reports for use in Social Security Disability cases.
For example, the Veterans Administration (VA) encourages its doctors to complete medical opinion reports when their patients request them. Veterans Health Administration (VHA) Directive 1134(2) establishes a policy requiring its health care providers to assist patients in completing VA and non-VA forms regarding their medical conditions and functionality.
There are several reasons you should not rely solely on medical records to prove your Social Security Disability claim. These include:
You are.
Social Security Ruling 17-4p is titled Responsibility for Developing Written Evidence.
The Ruling’s purpose is to clarify the SSA’s responsibilities and those of disability claimants and their attorneys to develop evidence in disability and blindness claims under the Social Security Act.
It states:
Although we take a role in developing the evidentiary record in disability claims, claimants and their appointed representatives have the primary responsibility under the Act to provide evidence in support of their disability or blindness claims.
Relying on the SSA to develop the evidentiary record and get the medical opinion source statements is risky. Take control of your case by working with your doctors to get the reports you need.
Your doctor’s medical opinion on disability can come in many formats. These formats include:
Each format has advantages and disadvantages. Use whatever method is more likely to result in your treating doctor completing a detailed report about what you can and cannot do – and why.
I recommend asking any treating doctor that you trust to complete two disability letters and reports.
Ask for one as soon as you apply for disability or soon after.
And ask for an updated medical opinion on disability when you find out your disability hearing date (if the SSA denies your initial application and request for reconsideration).
Presenting two medical opinions months (or years) apart can help you prove that your condition has worsened – and how and why.
A specific disability report that states your restrictions and explains the reasons for your limitations is helpful in your Social Security Disability claim.
A short disability letter stating that you are permanently disabled and unable to work is not. In most cases the Social Security Administration will ignore that type of letter or give it little weight. This is because the SSA decides if you meet the Social Security Act’s definition of disability – not your physician.
Your doctor’s disability letter must go further and give more detail.
Code of Federal Regulations Section 404.1513(a)(2) defines the term “medical opinion” and is a starting point for the information your physician’s disability report should include:
No.
You can talk with your medical providers and help them draft the medical opinion. This assistance includes explaining the Social Security Disability system, providing additional evidence such as reports from other health care providers, and giving an overview of what the disability examiner might find important.
But do not tell the doctor what to say.
No.
Do not ask a treating physician to give a written report discussing disability and what you can do unless you think the doctor will support your claim.
The SSA’s evidence rules and regulations require you to submit or inform the SSA about all evidence known to you regarding whether or not you are disabled. And the rules state that evidence includes not only objective medical evidence but also medical opinion evidence. This means you must submit a doctor’s letter if it hurts your case.
The SSA even requires you to submit a doctor’s negative or neutral opinion statement if you later convince the doctor to change the opinion and provide a more supportive letter.
These evidence rules are why I never recommend asking a doctor to write a disability report unless you have a good idea of what the doctor will say.
No.
A doctor can refuse to complete disability paperwork.
No.
But you have a much higher likelihood of winning your case than if you did not have a support letter.
A detailed disability report from a physician that has examined and treated you multiple times is the most critical piece of evidence you can present to the SSA.
Your doctor may refuse to complete Social Security Disability forms or attending physician reports for several reasons. These reasons may include:
The first step you should take when a doctor refuses to complete disability forms is to determine why.
For example, if your doctor does not believe you are disabled, you should not ask that doctor to write their opinions.
However, you have several options to persuade the doctor to help you win your disability claim if the problem is the doctor’s lack of time or familiarity with the court system. Or just an unwillingness to get involved. These options include:
If you are overwhelmed by the disability process or the Social Security Administration has denied your SSDI or SSI claim, call us for help: (804) 251-1620 or (757) 810-5614.
My firm has helped thousands of clients with Social Security Disability claims. We understand the importance of doctor disability letters and what they need to say, and we will present your case in the strongest way possible.