Monday, October 21, 2019

GETTING YOUR DOCTOR TO SUPPORT YOUR SSDI CLAIM

Your doctor can be of great value in getting disability benefits approved.  However, many doctors just won't get involved.  The basic reasons, I think are:  they are busy, their time is limited and valuable and there is nothing in it for the doctor.

Another problem is getting to the doctor.  Doctors have staff that are trained to keep patients away from the doctor except during paying medical appointments.  That's why you can't just walk in and talk to your doctor or get him on the phone.  So, you may not be able to get past the receptionist or front office staff to present forms to your doctor.  You might solve this problem by approaching your doctor during a regular, scheduled medical appointment.

What Do You Need from Your Doctor?

You need a form called a "Medical Source Statement" (MSS), sometimes called a Residual Functional Capacity (RFC) form.

This form lists your maximum functional capacity:  how long you can sit, stand, walk.  Maximum weight you can lift; what your limits are for reaching, handling, grasping, kneeling, bending, kneeling, crawling, etc.

Does the MSS Form Require a Special Examination?

No.  You want an estimate of function based on your doctor's history with you, not a special set of measurements.  You do not want your doctor to refer you to a rehabilitation specialist or other doctor to get tested, as this defeats the purpose of getting the information from your treating doctor.

Will a Letter From My Doctor Do Just as Well?

No.  First, I have never seen a doctor's letter that wasn't far to general and vague. It isn't enough for a doctor to say you can't work.  It isn't sufficient to say that you can't sit or stand very long.  We need to know how long you can sit or stand:  an hour, half an hour, less than half an hour? Second, doctors usually will not know the language that Social Security wants.  For example, Social Security has specific definitions in their regulations for words like rarely, occasionally, frequently, etc.  

Can My Doctor Decide If I Qualify for SSDI or SSI Benefits?

No.  That decision belongs to Social Security.  But your doctor may provide detailed evidence to help Social Security reach a favorable decision, based on the medical data in your file, including his or her opinions concerning how much work-related activity you can do.

Are Medical Records Enough?

We always get medical records, of course.  Often, we like to have more than the routine medical records--which simply do not detail the patient's functional abilities.  Medical records will not state how long a patient can sit, stand, walk or how much he/she can lift, for example.  Routine records will not tell us, for example, that the patient will need to sit down or lie down 3 times during an 8-hour workday.  This specific type of information comes from the Medical Source Statement or Residual Functional Capacity forms.

Which Doctor is Best for Providing an MSS/RFC?
  • It should be a treating doctor you have seen for a while.
  • A specialist is more helpful in some cases
  • The longer you have been treated by the doctor, the more influence his or her MSS/RFC will have.
  • The form must be signed by a Medical Doctor (MD), a licensed Physician's Assistant (PA), or in the case of mental impairments by a licensed Psychologist (Ph.D, Psy.D).  A licensed Optometrist may testify about diseases of the eye or vision; a licensed Podiatrist can testify about problems with the feet or ankles (only).  
  • Social Security will not recognize a statement from a chiropractor, nurse practitioner, licensed counselor (LPC), diet or nutrition expert, or most other practitioners.
Where Do I Get the Form Required?

The best place to get RFC/MSS forms is from your attorney.  Most doctors do not keep these forms at their office.  The claimant will need to obtain the form and take it to the doctor, or the attorney/representative can send to the doctor's office. Once the form has been completed by the medical professional, you should return it to your attorney/representative.  Be sure to keep a copy for yourself.
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THE FORSYTHE FIRM
Social Security Disability Counselors
7027 Old Madison Pike, Suite 108
Huntsville, AL 35806
CALL US (256) 799-0297
Email Us:  forsythefirm@gmail.com 

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