When you file a claim for Social Security disability benefits or receive notice of a medical review of your existing benefits, you should also submit letters or written reports from your treating physicians to explain to the Social Security Administration how your health condition(s) limit your ability to work. However, some doctors, especially those unfamiliar with Social Security disability claims, may make mistakes or oversights that undermine the effectiveness or persuasiveness of a doctor’s letter for the SSA.
The Importance of Doctor’s Letters in SSD Claims
During the initial review of a Social Security disability benefits application or medical review of a person currently receiving benefits, the Social Security Administration will review letters or reports from an applicant’s or recipient’s treating physicians. Doctor’s letters can provide context for the information in a person’s medical records or the results of their medical exams or diagnostic tests. Letters can also more fully explain how a person’s health condition(s) affect their daily activities and ability to work, including how those conditions restrict work activities like sitting, standing, walking, lifting, remembering, or following instructions. Thus, doctor’s letters can serve as critical evidence for an individual’s SSD claim.
Elements of a Doctor’s Letter
A doctor’s letter or report can help an individual secure or maintain SSD benefits by thoroughly addressing critical elements such as:
- The Patient’s Diagnosis – A doctor’s letter should identify a diagnosis of the patient’s condition(s) that cause their function limitations.
- The Patient’s Symptoms and Functional Limitations – In addition to diagnoses of medical conditions, a doctor’s letter should also describe the symptoms and functional limitations caused by the condition(s).
- The Expected Duration of the Patient’s Disability – Because a disability must last for at least 12 months or result in death for a person to qualify for SSD benefits, a doctor’s letter should state the physician’s opinion regarding the expected duration of the disability.
- The Patient’s Ultimate Prognosis – A physician should also give their opinion on what the patient’s condition will look like once they reach maximum medical improvement and how long it may take for the patient to reach MMI.
- Objective Medical Evidence of the Patient’s Condition – Doctors should support their diagnoses and opinions with objective evidence from the patient’s medical records, including exam findings, test results, or interpretations of radiology scans.
- The Physician’s Expert Medical Opinion – Finally, a doctor’s letter should state that the physician has given their opinions to a reasonable degree of medical certainty.
Common Mistakes in Doctor’s Letters
Unfortunately, doctors may make mistakes in the letters or reports they submit to the Social Security Administration, which may jeopardize a patient’s SSD application or benefits. Physicians with little experience with SSD claims may not know how to structure their letters or what information to include to give their patients the best chance to secure or maintain SSD benefits. However, patients’ legal counsel can help doctors prepare effective letters supporting SSD claims.
Some of the most frequent mistakes made in doctors’ letters in SSD claims include:
- Failing to Discuss Specific Functional Limitations – Physicians sometimes omit detailed discussions about their patients’ specific physical functional limitations and how those limitations affect their ability to work.
- Using Vague Language – The SSA may find a doctor’s letter less persuasive when it uses vague or ambivalent phrases like “some difficulties” or “could limit.”
- Failing to Cite the Medical Record – The SSA may discount a doctor’s letter or report when a physician fails to support their diagnoses or opinions with evidence from the patient’s medical record, such as exam findings or test results.
- Focusing Solely on Medical Evidence – A doctor’s letter may not provide a compelling argument to support a patient’s SSD claim if the report only focuses on medical facts without explaining how a patient’s mental condition or physical condition affects their daily activities or work capacity.
- Not Describing the Frequency or Duration of Symptoms – When a physician neglects to describe the duration or frequency of a patient’s limiting symptoms, the SSA may conclude that a patient’s condition does not qualify as a “disability” entitling them to SSD benefits.
Best Practices in Obtaining Doctor’s Letters
When asking your doctor to write a letter supporting your SSD claim, critical tips that can help you and your physician include:
- Consult an SSD Attorney – If your doctor has little experience with SSD claims, an SSD attorney can help them understand what kinds of information the Social Security Administration needs from a doctor’s letter so that your physician does not omit any necessary details.
- Prepare Questions for Your Doctor – You and your attorney can help your doctor fully address your disability claim in their letter by preparing a list of questions for your doctor to answer in the letter.
- Provide Context for Work Limitations – Your physician can boost their credibility with the Social Security Administration by offering context for their descriptions of your work limitations, such as how your limitations would affect your ability in common or realistic job scenarios.
How an Attorney Can Help with Doctor’s Letters
An SSD lawyer can help you work with your treating physicians to avoid mistakes in their letters or reports to the Social Security Administration to support your disability benefits claim. An experienced attorney can help your doctors ensure they’ve included all required information and supported their opinions with citations to the medical record. A lawyer can work with your physician to organize and present information in the most persuasive form to give you the best chance of success in your SSD claim.
Contact Our Firm Today for Assistance with Your SSD Claim
When you apply for SSD benefits or receive a notice for a medical review of your benefits, a well-drafted doctor’s letter can help you secure or maintain your financial benefits. Contact Disability Advocates Group Florida today for a free consultation with our SSD attorneys to learn more about working with your treating healthcare providers to obtain letters or reports supporting your benefits claim.