By: Elliott Andalman, Attorney at Law
Many people mistakenly believe that if their treating doctor reports that they are disabled to work, then they will win social security disability benefits. I wish it were that simple. Medical support from your treating doctor is generally necessary, but a conclusory statement of disability is never sufficient. Let us examine what medical information is necessary to win a claim for SSD benefits:
- Social Security Administration (SSA) reserves the right to determine disability to itself, so it is not required to consider your doctor’s statement that you are disabled to work.
- For all workers below age 50, SSA requires that you prove that you are unable to not only perform your job but any other job in the national economy. Thus, your doctor must consider you disabled from performing all work. Luckily, however, to date, SSA only considers full-time work to establish disability.
- In getting information from your doctor, you need the doctor to provide an explanation of the limitations on your activities caused by your illness that will prevent you from working. What those limitations are will vary, of course, depending on your medical diagnosis. Often your illness will cause symptoms such as pain, fatigue or inability to concentrate which will cause limitations such as the inability to work eight hours per day without unscheduled breaks, the inability to maintain regular attendance, the inability to maintain normal productivity, among many other possibilities.
- Fourth, in addition to the limitations on your activities, information from your doctor must include an explanation of why those limitations could reasonably be caused by your medical condition. To do this it is generally most effective to obtain a narrative report that should also include how long and how often the doctor has seen you, a brief history that you provided your doctor, your diagnosis, what test results and evaluations support the diagnosis, what treatment you have received, and what your prognosis is including how long your limitations are expected to last.Because reports take time for doctors to prepare, they may be expensive. To save time and expense, there are questionnaires that have been developed to try to address all of the relevant questions. However, the narrative report is typically preferable and usually carries much more credibility than a questionnaire.
- Fifth, SSA requires that your doctor submit a copy of his clinical records. The clinical records must not contradict the information in the report prepared by your doctor.Even when you can provide SSA with all of the medical information set forth above, you still may not win. SSA processes these cases through Disability Determination Services in each State. These state agencies hire their own doctors to review the medical information submitted on each claim as well as all of the information submitted by claimants about their activities of daily living. These doctors can disagree with the opinions presented by your treating doctor. Further, these state agencies often require claimants to be evaluated by doctors that they pay for. These doctors, who are called Consultative Examiners, can come to different conclusions than your own doctor.
The upshot is that disabled individuals often have a tough time winning disability benefits. If your disability claim is denied, you will only have 60 days to file an appeal. You should protect your rights by filing an appeal. You also should seek representation by counsel to maximize your chances of winning an appeal. If you need assistance in preparing your case, don’t hesitate to contact me for a free consultation.
About Andalman & Flynn, P.C.
Andalman & Flynn, P.C. serves clients throughout Maryland and the District of Columbia, offering compassionate, quality service and winning representation across a broad range of legal areas. With a concentration on disability benefits law and family law, the firm focuses on cases that impact the rights of everyone, and they are there for clients when responsive legal help is most critical. For more information about Andalman & Flynn, please visit https://www.andalmanflynn.com, or call 301.563.6685.