If you are applying for disability benefits, you must provide the Social Security Administration (SSA) with sufficient medical records, which at some point will include doctor’s letters. However, common mistakes in doctors’ letters — information that is too vague or that conveys an inaccurate impression of your disability — often result in claim denials. The best way to avoid these pitfalls is to consult an experienced disability benefits attorney.
Disability Law Group provides comprehensive legal services to the disabled and their loved ones. Our processes are designed to take the stress out of filing a disability benefits claim with a dedicated team of experienced staff and attorneys who only handle disability. We will be there every step of the way, from compiling the necessary medical records to submitting the benefits application, to assisting with doctor’s letters. Above all, we will work strategically to help you obtain the disability benefits you deserve.
What is required in doctor’s letters?
Although doctor’s letters, or opinions from your doctor about your disability, can mean the difference between a claim denial and obtaining these vital public benefits, they should contain certain factors in order to be persuasive and relied upon by the Social Security Administration (SSA). Simply stating that the patient, or applicant, is “disabled” or unable to work is typically not sufficient. In fact, you will want your doctor to indicate your limitations that relate to work.
Physical, mental and/or cognitive limitations are important to highlight so that SSA can evaluate whether these limitations would permit the applicant to work, either their past job or other types of work. Perhaps most important to this analysis is whether the limitations noted in the letter by the doctor are consistent with the medical evidence. In other words, it must be reasonable that the limitations reflected in the letter would apply to the claimant, or their patient, given what is stated in the treatment notes. For instance, if the individual claiming disability regularly treats with their neurologist regarding a traumatic brain injury or seizures, reporting episodes of mental fog, fatigue, headaches, and difficulty concentrating, one would expect that limitations concerning the need to lay down, take rest breaks or even be unpredictably absent from work would be reasonable.
On the other hand, if the letter by the doctor indicates that their patient is “unable to work” without more detail or any specific limitations, it is less persuasive and less likely to be relied upon by SSA in rendering their decision. Moreover, if the doctor’s letter is largely inconsistent with the medical reports – identifying limitations that are simply unsupported by the medical evidence itself – then it is similarly unpersuasive. Disability Law Group can assist you in obtaining all necessary evidence, including letters in support of your case from your doctors; our attorneys will review your case and draft specific forms tailored towards your condition and limitations for your doctor to review and complete. Ideally, in formulating their opinion, doctor’s letters should outline the individual’s “Residual Functional Capacity” (RFC), specifying work-related limitations supported by the records.
To meet the SSA’s requirements for demonstrating RFC, the statement must name your diagnosed condition(s), the date of the diagnosis, and the prognosis. The statement should also describe the ways in which you are functionally limited, that is how the condition limits your normal daily activities, and specifically address issues such as your:
- Level of physical strength
- Range of motion
- Limitations on walking, bending, lifting, or balancing
- Sensory deficits (sight, hearing, touch)
- Cognitive impairments (difficulty learning/retaining information or concentrating)
- Any other physical or mental limitations
The RFC statement should also indicate whether the medical condition(s) has lasted, or is expected to last for 12 months or result in death to be eligible for disability benefits. While any provider can prepare a letter outlining the patient’s limitations, it is recommended that the doctor(s) who have treated or known the person the longest, or at least spanning the timeframe of the alleged disability, provide an RFC statement. Moreover, if the individual is treating with any specialists for their disability, such as a rheumatologist, neurologist or cardiologist, for example, their opinion can be especially helpful in a disability case.
Common Mistakes in Disability Benefits Claims
In addition to administrative and procedural mistakes during the application process, disability benefits claimants make common mistakes such as not receiving ongoing medical care or failing to appeal a claim denial. Because roughly two-thirds of initial claims are denied, filing an appeal or a request for reconsideration, will likely be necessary, however, and failing to do so means that you could forfeit your right to these benefits.
This is another area in which Disability Law Group can help. We are highly experienced in all aspects of the appeals process, from submitting a Request for Reconsideration (within the appeal deadline which is typically 60 days of the claim denial) to filing an appeal before an Administrative Law Judge and handling disability hearings, to filing a lawsuit in federal court if necessary. At the end of the day, working with our disability benefits attorneys will increase the likelihood of your benefits claim being approved.
What is a consultative exam?
Depending on the circumstances, the SSA may require you to undergo one or more consultative exams — routine physicals, neurological exams, radiological tests (X-rays, CT Scans), mental status exams, and other tests — that could be a key factor in your disability benefits claim.
Consultative exams are performed by doctors contracted by the SSA to conduct independent examinations and report back to the agency. The doctor may find that (1) your condition supports the medical evidence already on file or (2) the medical record does not substantiate your claim. In any event, if you fail to make an appointment for a consultative exam without a valid reason (e.g. medical emergency), your claim will likely be denied. However, an experienced disability attorney can help you understand what to expect during this examination so that you go in prepared. Further, by obtaining an RFC statement from your doctor, your chances of being sent on a consultative exam may be less as SSA may find the opinion of the doctor, or treating specialist, to be persuasive evidence regarding limitations and an ultimate finding of disability.
Contact Our Experienced Disability Benefits Attorneys
The legal team at Disability Law Group has a well-earned reputation for being dedicated advocates of the disabled. We have command of the legal and medical complexities involved in disability benefits claims and will leverage our skills and experience to help you obtain the benefits that you need and deserve.
Our attorneys will collaborate with your doctor to ensure that the medical information provided with your application is thorough and accurate. We will also assist with preparing the RFC statement so that it supports the medical record. When you become our client, we will handle all the details of your claim, represent you in all dealings with the SSA, including disability appeals and disability hearings, and make sure your rights are protected. The sooner you contact our office for a free consultation, the sooner we can help you with your disability benefits claim.
