How Your Doctor'€™s Opinion Can Help Your Social Security Claim

May 26,2016
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An opinion from your doctor can help your claim for Social Security disability benefits or SSI.  Social Security decision makers place significant weight on a treating doctor’s opinion about a claimant’s ability to work.  But getting a proper opinion from your doctor is not always easy.  Why?  Because doctors are very busy people and not all doctors understand what information needs to be provided in an opinion letter. A White Plains Social Security attorney can provide your doctor with time-saving opinion forms and guidance about how to prepare an effective opinion

What Your Doctor’s Opinion Should Address

A doctor writing a note that says simply that you are disabled, even if it says you are disabled from a particular condition, is almost meaningless and could even cause the judge or adjudicator to have a negative opinion about your claim. Social Security Rulings provide that the decision maker is not to give any weight to such a conclusory statement made by a doctor.

A good statement from a doctor should contain certain things:

  • The date.
  • The doctor’s printed name and contact information.
  • The last time the doctor examined you.
  • The doctor’s signature and what his or her title or education level is, for example, M.D., Ph.D., etc.
  • Your diagnosis or diagnoses.
  • If you suffer from a physical condition, how much weight you can lift or carry, during what part of the day, and how long you can sit, stand, or walk, during an 8 hour work day.
  • If you suffer from a mental impairment, how well you would deal with the public, co-workers, or supervisors, how you would react to change in the work routine, and whether you have lapses in concentration or are easily distracted.
  • Some explanation of how your diagnosis or diagnoses cause the work-related limitations the doctor is saying you have and what diagnostic tests or other evidence supports this.
  • Job sustainability issues, such as a need to miss work, take extra breaks, leave early, or be late for work. Any vocational expert will acknowledge that a significant number of any of these needs will cause you to be unable to sustain any job, no matter how simple the job may be.

Doctors Whose Opinions Count

Social Security decision makers do not give the opinions of all medical providers the same weight.  Unfortunately, what your chiropractor thinks about your ability to work is not worth much.  The same goes for nurse practitioners and physician’s assistants.  The Social Security Administration wants opinions from doctors – M.D.’s, Ph.D’s, or D.O.’s.  That’s not to say that records from therapists, nurse practitioners, podiatrists, optometrists, and the like, are not important.  They are.  But, they are not appropriate sources for asking their opinion.

Overcoming Obstacles to Getting an Opinion From Your Doctor

                Using Opinion Forms

Social Security disability attorneys have developed forms that your doctor can easily complete to provide an opinion on your particular condition, whether it is physical or mental.  A good form also addresses the job sustainability issues mentioned above (i.e., need to miss work, take extra breaks, etc.).

The reason that a form the doctor can just fill-out and sign is important because doctors are really busy and their time is valuable.  You want to make it as easy as possible.  It may also be a better strategy for you ask the doctor to complete the form your attorney provides at your next office visit.  You should also provide a stamped envelope, addressed to your attorney, for the doctor to use if he or she does not have time to complete it and give it to you right then.  This is something to discuss with your attorney.

                The Functional Capacity Evaluation Trap

The attorney may prefer to send the form to the doctor himself or herself. However, there is an increasing tendency for doctors to reply to requests from attorneys to complete opinion forms by saying that they are not qualified to give an opinion, especially when dealing with physical impairments and limitations, and that the patient must undergo a functional capacity evaluation (FCE) to get those opinions.  This is not good.  It is also not true.

A functional capacity evaluation costs approximately $1,500 and insurance will not pay for it because the test is not medically necessary.  An FCE usually gets paid for or ordered only when a claimant has a concurrent workers’ compensation or personal injury case.  It is also a rather grueling ordeal, as the person conducting the test has you do short routines of activities seen in a workplace.  The subtests take most of the day to complete, and in some circumstances, may require more than one setting.

The testing is designed to detect whether you are giving your best effort, or not.  So, it is important that you do your very best on all parts of a FCE, if you and your attorney, or an insurance company, decide to send you for one.  The last thing you want is for the evaluator to say that you did not give it your best effort or were “faking it.”

                Getting Past the Nurse or Office Manager

The other thing you need to know is that the doctor’s nurse is trying to protect the doctor’s time.  That is another reason to make sure the form or request for the doctor to render some opinions about your ability to work actually gets to the doctor.  Invariably, the office manager or head nurse will say that the doctor won’t complete the form or render an opinion.  This is frequently not true.  Often, the doctor has told the patient that the doctor will support the patient’s disability application in any way possible.  You have a relationship with your doctor.  Your attorney may or may not.  This is why you may be the best person to take the form to your doctor to complete.  You are not asking for the doctor to say anything that is untrue, so this should not make the doctor feel uncomfortable.

For help with your Social Security disability claim, call a White Plains Social Security attorney at the Hermann Law Group.  We represent clients throughout the New York metropolitan area. You can reach us at 877-773-3030.