Having your doctor’s support is critical to winning your disability claim. This is because the Social Security Administration (SSA) makes part of its decision based on what your doctor says about how your condition affects you. This means that if your doctor won’t help you, it will be harder to get approved. However, there are ways you can improve your chances of winning even without your doctor.
A consultative examination (CE) is an examination performed by a doctor who has been hired by the SSA. CEs are not always helpful to the claimant; however, if you don’t have a doctor who will work with you, it may be helpful to request one.
Mental illness. If mental illness is the sole basis of your claim, a psychological CE will likely be scheduled for you without having to request it. However, if you suffer from anxiety, depression, or other mental illness along with a physical condition, it may be helpful to request a psychological CE.
If a mental CE is scheduled for you, make sure you have submitted evidence that supports your allegation of mental illness. Although the CE should have been given your medical records, make sure that you bring copies of anything that may be relevant. This includes treatment notes and proof of prescriptions, and any other information that supports your claim. You should also be honest with the evaluator—this means that you should not minimize, or exaggerate, your symptoms.
Specialist. Sometimes your doctor will not help with your disability claim because he or she does not have the expertise to assess the full effects of your condition on your ability to work. In this case, a CE with a specialist could be helpful. This may be true in cases of low I.Q., for example, where a general practitioner is aware of the patient’s disability but is unable to determine its extent. In this case, you can also request that the SSA administer an I.Q. test, in addition to an evaluation by a specialist.
An experienced disability attorney will be able to determine if a CE will help you with your claim, and to decide what kind of CE would best.
If your doctor will not help you with your claim, you can consider finding a new doctor. Note, however, that this can be helpful or harmful to your case. You need to be aware of and carefully weigh the pros and cons of finding a new provider.
Here are some possible pros to finding a new doctor.
Here are some possible cons to finding a new doctor.
If you do choose to find a new medical provider, make sure that you do not appear to be "doctor shopping." The SSA may decide you are doctor shopping -- that is, visiting new doctors until you find one who will say you're disabled -- if your records reflect visits to multiple doctors without establishing any sort of doctor/patient relationship with them.
Some doctors have a reputation of helping everyone and anyone with their disability claim. The SSA pays attention to doctors who work with claimants, and are aware that some doctors will support almost any claim. In these cases, the SSA may not give weight to the doctor’s opinion about your condition.
If you get to the hearing level and still do not have a supportive statement from your doctor, the administrative law judge (ALJ) who hears your case will want to know why a doctor won’t help you. Be ready to explain this honestly to the judge. In some cases, it may be wise to address this issue at the beginning of your hearing. An experienced disability attorney will know the best way to handle this situation.
Strong medical evidence may be able to counter some of the effects of having an unhelpful doctor. Although it can be hard, it will be extra important to take the time to gather any and all medical evidence related to your disabling condition. Here are examples of the medical evidence you should provide:
Relevant evidence. Before you submit a mountain of medical records, make sure you go through them and only include evidence that is relevant to your condition. ALJs and SSA employees will not wade through piles of irrelevant documents to look for what is helpful.
Bad evidence. Don’t weed out bad (unhelpful) evidence that may be in your records. ALJs are trained to spot holes that may indicate a claimant has removed relevant, if unhelpful, medical records. This will reflect poorly on you and may make the ALJ distrust you.
Although they are often disregarded, ALJs sometimes consider well-written letters from the people in your life familiar with how your condition has affected you. Here are some examples of letters that can help.
Caregivers. If you need caregivers to help you do daily tasks like cooking, cleaning, grocery shopping, or paying bills, it can be extremely helpful to have the caregivers write a letter that explains what they do to help. You must also be able to explain why you need assistance to do these tasks.
Former employers. If your former employer is aware of your medical condition and saw how it affected your ability to do your job, you should ask him or her to write a letter for you. Ask the employer to be as specific as possible in describing your job duties, how you did your job before you got sick, and the effects your condition had on your ability to keep working.
Getting approved for disability can be hard if you do not have a supportive doctor. An experienced disability attorney will have dealt with myriad cases where claimants did not have a supporting doctor and will have techniques and strategies that can help overcome this obstacle.