What Kind of Doctors Should I See To Strengthen My Disability Case?

28 Sep 2020

When you apply for Social Security Disability benefits, you have to provide the Social Security Administration (SSA) with adequate medical records and other evidence documenting your inability to work to support your case. In your application, you will list your medical care providers and you need to ensure that the SSA office receives all pertinent medical documents. This can make the difference between having your SSDI and SSI benefits claim approved or having it denied. The most important thing you should do to strengthen your disability benefits claim, and increase your chances of being awarded benefits, is to not just treat with your primary care physician, but instead also treat with appropriate specialist physicians for each of your health impairments or medical conditions.

If you have questions about what doctors you need to see and what medical documents will help support your SSDI and or SSI benefits claims, read on.

Which Doctors’ Records Do I Need?

When you are applying for Social Security disability benefits, it is important to collect all medical records from any doctors you have seen in relation to treating your disabling medical conditions. If you have multiple health impairments, you will need to send records from all of these doctors to the SSA. It is important to understand that Social Security must take into consideration the combined effects of ALL of your health impairments, not just those that are most severe.

Which Medical Documents Do I Need From My Doctor?

There are different types of medical documents you need depending on your type of disability. Here are a few examples of common SSD claims and the required paperwork you should gather for each.

Back Pain

If you file a Social Security disability claim because of back pain caused by lumbar or thoracic spinal stenosis, collect the following medical documents from all your treatment sources, including your primary care physician, orthopedist, neurosurgeon, physiatrist, physical therapist, and pain management specialist, and for any hospital visits:

Radiologists’ imaging studies reports (for X-rays, CT Scans, MRI, etc.) detailing the extent of the stenosis (SSA will not accept the actual test films/discs)
EMG reports documenting any nerve related involvement
Surgical records
Records from all visits with the above physicians, documentation of the medications prescribed, dosages, effectiveness or lack thereof and side effects, ongoing progress or lack thereof
Physical therapy plan and treatment notes
Physical residual functional capacity (RFC) assessments completed by your physicians

Mental Illness

If for example, your bipolar disorder or anxiety disorder prevents you from working, you will need to provide SSA with the following documentation:

Session notes from your psychiatrist and or psychologist (SSA does not consider non-Ph.D therapists/counselors to be acceptable medical treatment sources), which should include documentation of medications prescribed, effectiveness of medications and any side effects experienced, and your ongoing progress or lack thereof.
Psychiatric or psychological evaluations formally diagnosing you with bi-polar disorder or generalized anxiety disorder using the Diagnostic and Statistical Manual of Mental Disorders (DSM) including prognosis
Mental RFC assessment completed by your psychiatrist and or psychologist
If you have a substance abuse history, you will also need a statement from your psychiatrist or psychologist verifying that drugs and alcohol are not contributing factors to your mental health symptoms and limitations.

Multiple Impairments

If you have a combination of disabilities, including Type 2 diabetes, chronic obstructive pulmonary disease (COPD), or depression, you need the following medical documents from your providers:

A physical RFC (completed by a cardiologist, pulmonologist and endocrinologist),
A mental RFC (from a psychiatrist and or psychologist)
Psychiatric or psychological evaluations formally diagnosing you with bi-polar disorder or generalized anxiety disorder using the Diagnostic and Statistical Manual of Mental Disorders (DSM) including prognosis
A statement from your psychiatrist and or psychologist verifying that drugs and alcohol are not contributing factors to your symptoms or limitations of depression
Treatment notes from all of the above physicians, including documentation of medications prescribed, effectiveness of medications and any side effects experienced, diagnostic test results, and your ongoing progress or lack thereof

What are my chances of being approved for benefits?

The vast majority of Social Security Disability Insurance Benefits (SSDI) and Supplemental Security Income (SSI) applicants are denied at the initial application level and the reconsideration level of appeal, and must thereafter request and attend a hearing before a Social Security administrative law judge to have their case considered further. However, there are some conditions that are eligible for relatively quick, or even automatic approval. This is often by way of meeting or “equaling” the objective criteria requirements of the Social Security Medical Listings.

Discuss with your disability attorney the possibility that you may meet or “equal” one or more SSA Medical Listings.

Providing Your Residual Functional Capacity (RFC)

A residual functional capacity assessment (RFC) is a document that details a thorough assessment of your ability to perform work-related functions or activities with your medical impairment or impairments. There are both physical and mental health related RFC assessment forms. If your condition or conditions do not meet or “equal” a medical listing, documenting severely limited residual functional capacity will be one of the most important aspects of your case.

Physical RFCs

A physical RFC assessment should detail at least the following:

How much you can lift and carry and how often
How long you can stay sitting (uninterrupted) at any one time
How long you can stand (uninterrupted) at any one time
How far you can walk (uninterrupted) at any one time
How long you can sit, stand and/or walk in combination within an 8 hour period
Any environmental restrictions (such as sensitivity to dust or temperature)
Any postural restrictions (such as inability to stoop, bend, kneel, or reach overhead)
Sensory limitations (vision or hearing difficulties).
Whether you need to lay down during an 8 hour period
Whether you need to sit and have your legs elevated during an 8 hour period

An experienced disability attorney will provide each of your doctors with appropriate RFC forms with completion instructions (as well as other disability related questionnaires as appropriate to your particular medical conditions).

Mental RFCs

A mental RFC assessment will include multiple areas of daily functioning, including but not limited to:

Your ability to understand, remember and carry out simple instructions
Your ability to interact appropriately with co-workers
Your ability to interact appropriately with supervisors and react to criticism
Your ability to interact appropriately with the general public
Your ability to maintain appropriate dress and hygiene
Your ability to effectively concentrate/focus and remember
Your ability to understand and effectively follow written and or spoken instructions
Your ability to complete tasks correctly in an appropriate time frame
Your ability/reliability to attend work regularly (arrive in a timely manner each work day, and remain at work for the entire work day)

Contact an SSD Attorney for Help

Providing the SSA with the appropriate medical documentation is key to having your Social Security Disability claim approved. If you need help determining which documents you need and which doctors to see, contact experienced Social Security Disability attorney Sara J. Frankel. Attorney Frankel is a former Social Security Administration staff attorney who has been helping clients in Massachusetts and Rhode Island for almost three decades. She will guide you through the SSDI and SSI application process, make recommendations for what types of specialist physicians you should treat with to strengthen your claim for benefits and ensure that the correct documentation is obtained from your treatment sources and submitted to SSA in a timely manner.

Call or email Attorney Frankel today for help with your case!

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