Tuesday, November 18, 2008

A Letter from Your Doctor for Social Security Disability or SSI

...may or may not help you win your disability case. How can such a letter help you? If your claim is strong and your physician is willing to provide a detailed statement that addresses your functional limitations (this type of statement fits the bill of an RFC form), the statement can go a long way toward winning a disability claim.

However, and this is the sad part, even a very strong statement from a treating physician may not be particularly useful at the initial claim (application) or reconsideration levels. Why so? Because DDS (disability determination services) unit supervisors tend to run their own show. As a disability examiner, I frequently saw supervisors compel the examiners working in their processing units to practically ignore statements from physicians.

On that matter, I also saw unit supervisors---who, just remember, are not medical professionals and have zero medical training--force the physicians attached to their units as medical consultants (i.e. social security doctors) to change the RFC assessments they had previously made. In other words, when the supervisor didn't agree with an approval, they forced both the social security doctor and the disability examiner to turn the case into a denial (because, as I've said many times, these supervisors look after their own hides and try to avoid any quality control returns from DQB).

Now, this is not to say that getting your doctor to send in a statement, or completed RFC (residual functional capacity) form, on your behalf is a bad idea if your claim is currently pending at the application or reconsideration appeal level. In fact, sending in such a statement may win your case for you. However...because of the nature of disability claim processing at levels prior to the hearing level, your doctor's statement may not carry as much weight.

And that is particularly sad that the system operates that way, in light of the fact that RFC statements routinely help to win disability claims at hearings.

How are hearings different? Here are just a few ways:

1. Hearings are conducted by administrative law judges who do not have direct-line-of-authority supervisors, i.e. they can't be told what to do.

2. Hearings are different from the other steps in the system in that you get to meet the adjudicator (decision-maker). You also get the opportunity to have your disability attorney present an argument for approval on your behalf.

3. Judges at hearings actually respect the opinions of treating physicians, as long as the physician's statement is in line with the established record of medical treatment provided by the physician.

Return to the Social Security Disability SSI Benefits Blog

Other Posts

How to Qualify for Disability - social security disability or SSI
Social Security Disability and Medical Benefits from Medicare
What are the chances of winning Social Security Disability or SSI on an appeal?
How many people win Disability Benefits from Social Security ?
The Criteria for Social Security Disability and SSI
How to Claim Disability Benefits from the Social Security Administration
SSI Claim for Disability Benefits
Should You Appeal Your Social Security Disability Denial?

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