The medical documentation in the record can make all the difference in whether an individual will qualify for Social Security disability benefits.
1. Weight of Evidence
Historically, the opinion of your treating physician was entitled to more weight than that of a physician who merely examined you or reviewed your file. The Social Security Administration has recently published a final rule that changes the way treating physicians’ opinions are evaluted. Under the new rule, effective March 27, 2017, Social Security will give no special weight to the medical opinions of a treating provider and instead will evaluate all medical findings equally for their “persuasiveness” based on consistency and supportability.
2. Acceptable Medical Sources
Under Social Security law, all medical providers are not created equal. The new rule cited above added physician’s assistants and advanced practice registered nurses (like a nurse practitioner) to the short list of medical providers who are acceptable medical sources to diagnose impairments. As always, opinions by MDs, PhDs, PsyDs and DOs carry more weight than those with other degrees such as social workers, naturopaths and chiropractors.
Especially For Healthcare Providers:
1. Encouraging Your Patient to Apply
Although the Social Security system is set up for applicants to apply for benefits fairly easily over the phone, it is nevertheless an intimidating process for the disabled to deal with a large bureaucracy. If you believe your patient has a disability that will last longer than 12 months but the disability is still in the initial stages, you should encourage your patient to apply, because the date that he applies will determine the amount of benefits he can receive.
2. Persuasive Medical Opinions
The most persuasive medical opinions are those that offer solid reasoning rather than strong advocacy. It is helpful to state that a patient would be unable to work if that conclusion is explained and is consistent with the medical chart notes. It is very helpful to say your patient is unable to get himself to work every day; withstand a consistent 40-hour work schedule or complete tasks in a timely way; accept supervision; get along with coworkers; or concentrate. The more specific you can be, the better. It is always counterproductive to state that a patient “should receive benefits” or “is eligible for disability”.
When making statements in the chart such as “the patient is doing better,” it is helpful to remember that the Social Security Administration can misuse such statements. Qualifying such statements by noting that symptoms wax and wane or that improvement is slight or temporary, if that is the case, will give the SSA a more realistic picture of your patient’s true condition. Of course, remarks about “secondary gain,” “exaggeration of symptoms,” or “malingering” are very damaging to a claimant’s case, and we hope that you will make them only where there is clear evidence to support them.
Our office, Thomas, Coon, Newton & Frost, takes calls from claimants at any stage in the process, whether we represent them or not.
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