Having a doctor on a claimant's side makes a world of difference in a Social Security Disability case. Unfortunately, many of the persons who are considering filing for disability seem to be unaware of this important fact. The opinion of the doctor or doctors who treat a claimant can make or break a disability claim. For this reason, I would like to provide some helpful hints on how to enlist your doctor's help in your SSDI or SSI case and how to make the best use of his or her medical opinion regarding your physical or mental limitations. In addition, I would like to provide some suggestions on what to do in circumstances when a doctor refuses to cooperate with the case.
- YOUR DOCTOR NEEDS TO KNOW YOU AS A PATIENT: In order to make the best use of the opinion of a doctor in a Social Security case, a lawyer needs to establish that the doctor has been treating the patient long enough to be able to form a credible opinion. Simply stated, the more the doctor knows you, the more weight Social Security is required to give to his or her opinion. Your doctor's opinion has to be given controlling weight, unless the judge can cite specific reasons why it should be disregarded. One of the reasons most commonly cited by judges for giving little weight to a medical opinion is that the doctor did not treat the claimant long enough to be able to form a credible opinion. Likewise, many doctors feel uncomfortable issuing opinions or helping patients that they have just begun to treat. For this reason, I often recommend to clients not to bring up the issue of disability with a doctor that they have just begun seeing. I believe that doctors are often irked when a patient brings up the issue of his or her social security disability case during their first or second visit. Therefore, whenever possible, a claimant must give his or her doctor reasonable time to form an opinion with respect to his or her limitations.
- TALK TO YOUR DOCTOR BEFORE FILING YOUR CASE: Before a Social Security disability claim is filed, it is a good idea to ask the treating physician whether he or she will support the claim. Moreover, the claimant should specifically ask whether the doctor would be willing to complete a questionnaire stating his patient's limitations. However, I think that before posing the question, the patient should engage in a dialogue with the doctor regarding problems performing specific work related tasks. Ideally, this dialogue should take place over the course of several office visits. I believe that a doctor is more likely to support a claim when he has had a chance to openly discuss the case with his patient beforehand. I believe that doctors are reluctant to help patients with their disability claims when they are unexpectedly asked to support a disability claim.
- REMEMBER THAT YOUR CONVERSATIONS WITH YOUR DOCTOR ARE OFTEN RECORDED IN THE MEDICAL RECORD: Many of my clients are unaware of the fact that doctors often transcribe in the medical record the content of their conversations with their patients. In fact, doctors are known to record specific statements made by their clients that pertain to their disability claim. Unfortunately, I have found several instances where my clients' statements have ruined their chances of getting their claim approved. Disability claimants should be very careful with what they tell their doctors when they ask for a medical opinion. Don't joke around with the doctor on how desperately you need the money from Social Security or how you have to look really bad in order to win disability. Keep in mind that your comments could be misconstrued very easily and remember, it is never a good idea to suggest to a doctor to exaggerate the severity of a condition or an illness, or to ask the doctor to be dishonest in any way.
- GIVE YOUR DOCTOR A BRIEF QUESTIONNAIRE THAT GOES TO THE HEART OF YOUR CLAIM: Social Security Disability Lawyers often prepare questionnaires for their client's doctors. These questionnaires ask the treating physicians to state the extent and the nature of their patients physical and mental limitations. When preparing these questionnaires it is important to keep in mind that doctors don't have a lot of time in their hands and that they dislike having to spend time completing forms. For this reason, I like to keep my questionnaires brief and to the point. Moreover, the questionnaire should go right to the legal issues that are most relevant to the case. For example, the questionnaire should specifically ask questions that could help a judge decide whether the claimant's case falls within a specific Social Security rule or guideline. I believe that the best way to obtain a good opinion from a doctor is by giving him or her one of these questionnaires. (In my office we call these questionnaires: "medical source statements".) Instead of questionnaires, some doctors prefer to write a letter in support of their patient's disability claim. I often find that these letters are not very effective because, in many instances, they fail to address the specific legal issues being decided by the adjudicators in the case.
- OFFER TO COMPENSATE YOUR DOCTOR FOR HIS OR HER TIME: Whenever possible, it is a good idea to offer to compensate the doctor for the time spent completing the questionnaire. Most of the time, the amount paid is just a nominal sum. However, I believe that doctors often appreciate the gesture and spend additional time and effort when their patient offers to remunerate them for their valuable time.
- IF YOUR DOCTOR IS UNCOOPERATIVE, CONSIDER FINDING A NEW ONE: Let's face it. Some doctors don't want to help their disabled patients get benefits. Its probably not worth your time trying to convince them to complete a medical source statement for your case. Under those circumstances, its probably a good idea to consider changing doctors. I know that this type of decision can be very difficult. However, I have found that in many instances a claimant can get a new doctor that is more cooperative with their case without having to sacrifice the quality of their care. Naturally, claimants should not wait until the last minute to get a new doctor. The earlier they get on the right track, the better.
- DOCTORS WHO ARE NOT SPECIALISTS IN YOUR MEDICAL CONDITION CAN ALSO HELP YOUR CASE: An alternative to finding a new doctor is asking one of your treating physicians who is not a specialist in your particular condition to help with your case. I have found that primary care physicians can often issue very credible opinions which are well supported by the medical evidence in the record. In many circumstances these opinions can be extremely helpful. Don't be discouraged if your specialist does not help you. The Social Security Administration knows that highly paid specialists such as neurosurgeons often refuse to complete medical source statements. I believe that you can still win, even when your neurosurgeon refuses to complete a medical source statement. I recently won a case in which the neurosurgeon refused to help his client. Fortunately, prior to filing for disability, my client had seen a neurologist on several occasions for some problems related to his spinal cord condition. My client went back to the neurologist and was able to obtain a very well reasoned medical opinion. The opinion from the neurologist, combined with a questionnaire completed by his primary care doctor, was enough to win him disability benefits.