Doctor’s Letters and Common Mistakes
Updated: Dec 1, 2021
Medical records are the most important evidence in Social Security Disability claims. What a claimant’s doctor says about them in their own chart notes directly impacts the likelihood of a favorable outcome. The opinions of treating or examining physicians can be significant, but they are only as important as they are supported by and consistent with the medical records. If treatment records do not provide sufficient support for a medical opinion, it is of little value. Many applicants believe that doctor’s letters supporting their claim will help prove they meet Social Security’s definition of disability. Unfortunately, this is not always the case.
The opinions of a treating physician can go a long way if they provide the right information. However, not all medical opinions are created equal. For example, a letter from a treating doctor that generally states the patient is “too disabled to work,” or the patient is “disabled in my professional opinion,” helps very little, if at all. This is because Social Security regulations provide that only the Administration may determine whether a person meets their specific definition of disability. In other words, your treating doctors may be very qualified to provide an opinion about the nature and severity of your limitations, but they are not considered qualified to decide whether those limitations are disabling as a matter of law. As such, these brief, general opinion statements are typically dismissed as “not persuasive.”
Likewise, written statements from a treating doctor may convey an inaccurate impression of your medical impairments, or fail to include important information about the extent of your functional limitations and abilities. Unsupportive medical opinions, where your treating doctor states you are less limited than you actually are, can be used as a basis for denying disability claims even if the medical records say otherwise. So, letters, forms or other written opinion statements provided by a treating doctor are only as helpful as they are supportive and consistent with the medical evidence.
The foregoing issues represent just a few of the numerous pitfalls to be aware of when pursuing a disability claim. For this reason, it is important that claimants work with an experienced disability attorney from the time they file their initial application. Keep reading to learn more about doctor’s letters, consultative exams, and common mistakes made by disability claimants.
Should My Doctor Write a Letter if I Apply for Disability Benefits?
A doctor’s letter alone cannot prove that you meet Social Security’s definition of disability. An opinion about your residual functional capacity to perform full-time work is most helpful. Such statements provide medical opinions about specific physical and/or mental limitations and abilities a claimant has, and include examples of clinical findings that support those opinions – including copies of chart notes and reports.
A helpful medical opinion will fulfill two important purposes. First, it will provide details about the claimant’s diagnoses, treatment history, and prognoses. Second, it will set forth a medical opinion regarding the specific functional limitations resulting from the claimant’s impairments. Of greatest concern is the claimant’s ability to perform basic work functions, such as:
Sit, stand, walk
Push, pull, lift, carry
Reach, handle, finger, feel
Stoop, kneel, crouch, crawl
Understand, apply, and carry out instructions
Concentrate, persist, and maintain pace
Interact with others
Adapt and manage self
Medical opinions and statements as to your limitations and abilities should be written and provided by your current treating physicians. The more experienced and familiar the doctor is with your treatment and medical history, the more persuasive their opinion will be.
Common Mistakes When Applying for Disability Benefits
Without the guidance and expertise of a disability attorney, applicants often make the following mistakes:
They do not timely appeal administrative findings of “not disabled” and give up after the first denial of their initial application.
They do not consistently pursue and receive medical treatment for their impairments.
They assume Social Security will obtain all of their medical records before evaluating their claim.
They do not provide detailed information or report updates important to the evaluation of their claim.
These common missteps can either stop your claim in its tracks or increase the probability that the Social Security Administration will deny it at each step of the process.
If you are frustrated by SSA’s denial of your claim, know you are not alone. At least two-thirds of disability claims are denied on initial application, and even more are denied on reconsideration. This is why it is critical that you appeal each denial. If denied for a second time, you can request a hearing before an administrative law judge. The majority of disability claims are won at the hearing level.
With many medical conditions, applicants may sometimes feel as if continued treatment isn’t helping. Even then, you should not discontinue regular medical care. If you are not consistently treating for your impairments, there will be no evidence to support a favorable finding of disability. Without these important records, your disability claim may be denied once more.
Each step of the administrative process is significant in disability claims. It is during this time that evidence can be obtained, and the record can be developed to build the strongest case possible. The process can be lengthy, confusing, and daunting, which is why claimants should seek qualified representation as early as possible. Working with an experienced disability attorney will increase the likelihood that a claim will be thoroughly and accurately developed, which will in turn increase the probability of a successful outcome.
Consultative Exams in the Disability Claims Process
Depending on the specific facts of your case, you may be asked to attend one or more consultative examinations with an independent doctor or psychologist. There are two types of consultative examinations, mental and physical. These appointments are often brief, and may involve mental and physical assessments, formal testing, radiological or other impairment-related laboratory tests, clinical interviews, and review of medical evidence from your treating doctors. Reports from these exams can supply important medical and opinion evidence, potentially impacting the outcome of your claim.
The goal of a consultative exam is to assess your physical or mental limitations and abilities at the time it is conducted. In other words, the findings on these exams do not reflect a full and accurate picture of your medical impairments from the time you alleged disability. Rather, they provide a snapshot of your functional status based on that one-time evaluation. Generally, consultative exams rarely help claimants in their effort to obtain disability benefits . More often, the opinions and findings set forth in consultative examination reports have little probative value. You still must attend any consultative exams scheduled by SSA. If you fail to attend a consultative exam without good cause, SSA may use it as a reason to deny your claim.
Your Social Security Disability Benefits Specialists
Applying for disability benefits is typically a lengthy and complicated process. That’s because the Social Security Administration requires strong and persuasive evidence that documents limitations from one’s disability and how they prevent the claimant from working. These benefits are critical in helping those with physical and mental impairments who can no longer work.
Kapor Davis and Associates has worked with clients throughout Southwest Ohio, Southeast Indiana, and Northern Kentucky for more than 40 years. Each disability attorney with our firm offers compassion and expertise to help you through the application, appeals, and hearing process. We aid you in navigating these stages so you can better focus on your health and wellbeing. To get started, reach out to us through our convenient contact form. You can also call our offices at (513) 721-2820.
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