Having your doctor's support is critical to winning your disability claim. The Social Security Administration (SSA) bases its decision in part on what your doctor says about how your condition affects you. That makes it harder to get your disability claim approved if your doctor won't help you—but not impossible.
You can improve your chances of winning disability benefits even when you don't have your doctor's help. Here's what you need to know.
Ordinarily, your doctor's diagnosis and treatment notes would be a central part of the medical evidence you'd present to Social Security. But when you don't have a doctor, or your doctor doesn't support your disability claim, you can ask Social Security to schedule a consultative examination (CE).
A CE is a physical or psychological examination performed by a Social Security doctor or psychologist. Consultative exams don't usually generate a lot of medical evidence to support a disability claim, but if you don't have a doctor who will work with you, it might be helpful to request one.
If mental illness is the sole basis of your claim, Social Security will likely schedule a psychological CE for you—even without you requesting it. But if you applied for disability primarily for a physical condition, and you also suffer from anxiety, depression, or another mental illness, it can be helpful to request a psychological CE.
If a mental CE is scheduled for you, make sure that you've submitted evidence that supports your claim of mental illness to Social Security. The psychologist Social Security sends you to should have your medical records. But you should also bring copies of anything that might be relevant to your case with you to the CE, including:
During the CE, be honest with the evaluator—don't minimize your symptoms, but don't exaggerate them either. You're asking Social Security to grant your disability claim based largely on your testimony about your impairment, so your credibility is essential to your success.
Sometimes your doctor doesn't have enough expertise to help prove your claim. If your doctor doesn't have the knowledge or training needed to assess the full effects of your condition on your ability to work, a consultative exam with a specialist could be helpful.
For example, if you're seeking disability benefits because of a low I.Q., a general practitioner might be aware of your disability but is unable to determine its extent. In a case like this, can request that Social Security send you for an I.Q. test along with an evaluation by a specialist.
An experienced disability attorney will be able to determine if a CE will help you with your claim and help you decide what kind of CE would be best for your case.
If your doctor won't help you with your claim, you can consider finding a new doctor. Note that this move could help your case, but there's also a chance it could harm it. You need to be aware of and carefully weigh the pros and cons of finding a new provider.
Pros: The ways finding a new doctor could help your disability claim
Cons: Why getting a new doctor might harm your Social Security case
If you choose to find a new medical provider, make sure that you don't appear to be "doctor shopping"—that is, visiting new doctors until you find one who's willing to say you're disabled. Social Security might decide that you're doctor shopping if your records show you've visited several doctors without establishing any sort of doctor-patient relationship with them.
Some doctors have a reputation for helping everyone and anyone with their disability claim. The SSA pays attention to doctors who work with disability applicants and is aware that some doctors will support almost any claim. In these cases, Social Security might not give much weight to the doctor's opinion about your condition.
If you get to the Social Security hearing level and still don't 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. An experienced disability attorney will know the best way to handle this situation.
Strong medical evidence might enable you to counter some of the effects of having an unhelpful doctor. Although it can be hard, it's important that you take the time to gather any and all medical evidence related to your disabling condition.
Here's the kind of medical evidence you should provide to Social Security:
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, Social Security employees, and claims examiners might not take the time to wade through piles of irrelevant documents to find what's helpful.
Don't try to weed out bad (unhelpful) evidence that might be in your records. ALJs are trained to spot holes that can indicate you've removed relevant, if unhelpful, medical records. This will reflect poorly on you and could make the ALJ distrust you.
A qualified disability attorney or advocate can help to minimize the effects of medical records that could harm your case.
Although they're often disregarded, ALJs will 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 could help.
Caregivers. If you need caregivers to help you do daily tasks like cooking, cleaning, grocery shopping, or paying bills, it can be helpful to have the caregivers write a letter to Social Security that explains what they do to help. You'll need to be ready 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, a letter from your former boss could carry a lot of weight. Ask the employer to be as specific as possible in describing:
It can be hard to get approved for Social Security disability if you don't have a supportive doctor. But it isn't impossible, especially if you get help from an experienced disability attorney.
A lawyer who specializes in Social Security disability claims will have handled many cases where claimants didn't have a supporting doctor and knows techniques and strategies that can help overcome this obstacle. Plus, you don't have to pay a disability attorney unless you win your claim.