Your Doctor's Role in Your Social Security Disability Claim
Feb. 15, 2023
The Social Security Administration (SSA) is in charge of overseeing two federal programs that provide disability benefits. Social Security Disability Insurance (SSDI) is for those who, through tax deductions at work or through self-employment taxes, have paid into the Social Security system. The other program, called Supplemental Security Income (SSI), is funded outside of Social Security but administered by the SSA.
To apply for SSDI, you will need to prove to the SSA that you are suffering from a mental or physical condition that will last at least 12 months, or until death, and will prevent you from performing any substantial gainful activity (SGA). You must also have paid into the Social Security Trust Fund and earned enough “work credits” to qualify for the program.
SSI, on the other hand, is aimed at low-income individuals based on age (65 or older), blindness, or another disability regardless of age. You don’t have to accumulate work credits to qualify for SSI since it is paid for out of general revenues, not the trust fund.
If you’re facing a condition that prevents you from working and are considering applying for disability benefits, you will need an evaluation from a physician to verify your disability. Even so, first-time applicants are turned away more than half the time, often due to not providing sufficient medical evidence.
If you’re located in or around El Dorado, Arkansas, and need assistance understanding or qualifying for SSDI or SSI, contact the Rushing Law Firm, PLLC. Our Social Security Disability Attorney will answer all your questions, help you prepare the evidence for your claim, and then guide you through the process. We also proudly serve clients in Magnolia, Camden, Crossett, and throughout Union County, Columbia County, Ashley County, and Ouachita County, Arkansas.
Visiting Your Doctor About a Disability
First of all, don’t file a claim before visiting your doctor about your condition. Physicians and their staff generally are piled high with paperwork -- submitting insurance claims, keeping records and charts, and answering queries from Medicare and the SSA. You should expect that it may take some time for your physician to get around to compiling the medical records you need for your SSDI claim. Therefore, come prepared and offer as much input as you can about your condition.
Before your appointment date, compile a list of all the symptoms you’re feeling and the limitations that you’re suddenly facing. Be specific about how your condition affects your ability to work. If you’re a warehouse worker with a severe back condition that prevents you from carrying out your duties, specify that to your doctor. If you have another condition that makes it painful or prevents you from carrying out your day-to-day responsibilities, even if desk-based, spell that out in clear detail.
When you arrive for the appointment, be sure to explain to your doctor that you are applying for SSDI (or SSI) and then go over your list of limitations and conditions. The more specific your doctor can be in providing medical information about your disability, the better your chances become, but you cannot just dictate what the doctor will report. Try to explain that the more comprehensive the information sent to the SSA is, the better your chances are.
If your doctor agrees with your self-assessment, ask for a letter from the doctor spelling everything out. If they ask for a form to fill out, there is one available from the SSA called a Residual Functional Capacity Assessment Form. There are two forms, one for a mental condition and one for a physical condition. For SSDI, it is important that your doctor details how your condition prevents you from doing the tasks you are required to do at your place of employment.
Your Doctor’s Role in Your Disability Claim
The SSA and its Disability Determination Service (DDS) staff will rely heavily on the input from your doctor, so you should work closely with them to provide as complete a package of medical evaluations and evidence as possible. This might even include X-Rays, test results, and even MRI readings.
The DDS evaluators do indeed reject a great number of initial claims, sometimes as high as 70 percent. They also may opt to ask you to undergo what is called a consultative exam by a medical professional of their choosing, which the SSA will pay for. You can request that the results be sent to your doctor, and you should do so.
If after all this, you are still denied, there are several steps you can take to appeal, starting with a reconsideration, which means that another DDS examiner will review what’s been submitted. As your appeal process goes on, you will need to ascertain what evidence or statement by your doctor will help turn the tide for you and then work with your physician to provide the needed input.
What Is an “Accepted Medical Source?”
Documentation of a claimant's impairment must come from medical professionals defined by SSA's regulations as "acceptable medical sources."
These sources include licensed physicians (medical or osteopathic doctors); licensed psychologists; licensed optometrists for visual impairments; licensed podiatrists for impairments of the foot or ankle; licensed speech-language pathologists for speech or language impairments; licensed audiologists for hearing impairments; and licensed advanced practice register nurses (APRNs).
Speak With an Experienced Attorney
The disability claims process can be lengthy and challenging. It’s best to provide a clear and complete package of documentation when applying for benefits. In addition to acceptable medical sources, you can also include testimony from family members or coworkers attesting to your impairment.
Consulting with an experienced Social Security Disability Attorney is highly recommended to increase your chances of successfully navigating the system. If you’re in or around El Dorado, Arkansas, contact our team at the Rushing Law Firm, PLLC. We will work closely with you to help you assemble the medical and other evidence needed and then guide you every step of the way, including any appeals that may need to be pursued.