This article will discuss and explain four of the most important things you need to do to win your Social Security Disability case.
GO TO THE DOCTOR AND GET TREATMENT EARLY AND OFTEN.
Social Security disability cases are based on medical evidence. The Social Security Administration reviews the medical evidence for objective evidence, subjective complaints, and opinions of your doctor. Doctors with specialties are considered better then general doctors.
Assume it takes 2 years to get to court and you are the judge deciding your case. There are two people with the exact same disabilities, objective tests, and doctors’ opinions. The tests include an MRI showing severe spinal stenosis and an EMG/NCV test showing lumbar radiculopathy. After the tests are done
- PERSON ONE- goes to their primary care doctor every six months and complains about their symptoms.
- PERSON TWO- goes to their primary care doctor a month after the tests are done and then starts seeing an orthopedic specialist. (Social Security likes specialists better than general doctors) The following month, the orthopedic doctor advises that you try physical therapy for two months and come back if you are not better. If you don’t go back, Social Security assumes you got better. Now you have 20 physical therapy visits in those two months. Two months are up, and you go back to the orthopedic doctor who wants you to try these two different medications. If they don’t work, come back in 2 months. This goes on for two years. The Orthopedic has you try medication, pain management, seeing a physiatrist, steroid injections, and try a tens unit.
It has been two years and you go to court. PERSON ONE has been to the doctor 4 times. PERSON TWO has been to the doctor at least 16 times and has tried to get better with several different treatments. The judges can’t give everybody benefits. If you were a judge, who are you going to award benefits to? It is not really as much about how many times you have been to the doctor as it is the documentation from each visit showing you are still having the same symptoms.
This illustrates why it is easier for a judge to find a person disabled that goes to the doctor more often. The more documentation the better!
COMPLAIN ABOUT YOUR LOSS OF FUNCTION CONSISTENTLY.
Going to the doctor early and often is not enough to win a case. You need to complain about the same problems consistently. Sometimes you may have additional problems, but you should always complain about your basic problems as well.
Talk in terms of functional limits, these are things that would apply at work. The following are three examples that can easily be put into loss of work function:
- Migraine headaches: “I have 3-5 migraine headaches per week. They last 2-6 hours, and I am in bed in a dark room for that entire time.” This shows that you would need 3-5 days off work a week for at least 2-6 hours.
- Lumber radiculopathy: “The pain in my back or legs is so bad I can only stand for 10 minutes at a time, then I need to lay down for 20 minutes.” This shows that you are not able to work standing for more than 10 minutes.
- IBS disorder: “I have to go to the bathroom at least 6 times per day. Each time I am in the bathroom it takes me at least 20 minutes.” This shows in Social Security terms that you would need 6 bathroom breaks a day for at least 20 minutes.
One of the big problems with medical records is that doctors diagnose medical conditions in terms of mild, moderate, and severe, and pain on a scale of 1-10. This lets the Social Security Administration interpret what that means. If medical records fail to state your functional complaint and the doctor’s records simply state that you have severe migraine headaches, then the Social Security Administration can interpret a severe headache as once a month, or that you can still work through them If your doctor’s records say severe lumbar radiculopathy, the Social Security Administration can interpret that to mean you can still stand and walk 2 hours at a time and sit 6 hours of an 8 hour day. The doctor’s records may say you have very severe IBS, but that does not tell the Social Security judge how often you need to go to the bathroom or how long it takes you each time. This is why we tell people to use numbers when explaining your problems.
GET OBJECTIVE TESTS.
It is always easier to win a disability case with an objective test that confirms your complaints. That is why it is very difficult to win a fibromyalgia case, even though they have a Social Security Ruling (SSR) that explains what is needed to win with fibromyalgia. (SSR 12-2p.) Another common problem is mental health, and the only real test that can be done to help win a mental health case of any kind is a neuropsychological exam. The best way to win a bipolar or depression case is with multiple hospitalizations during the relevant time period. Hospitalizations from more that 2 years ago do not seem to count to Social Security judges. Also, while there is no actual objective test, it seems like the Social Security Administration looks at hospitalizations as a way to separate the severe cases from the non-severe cases.
OBTAIN MEDICAL SOURCE STATEMENTS FROM YOUR MOST SPECIALIZED TREATING DOCTOR.
A medical source statement is a very specific statement from your treating doctor about what you are functionally capable of doing. It is an opinion. There are two types, one for physical limitations and one for mental limitations. The more of these statements you get from treating doctors the better! It should be supported by the treating doctor’s notes or physical therapy notes. Social Security prioritizes these opinions based on consistency with the medical records, supportability of the medical records, and the specialty of the doctor providing the medical source opinion. You can obtain one of these questionnaires from your representative.
These are not statements saying you cannot work. The Social Security Administration says that it is their job to decide whether you can work and not your doctor’s. It is also not a statement from your treating provider explaining how obtaining Social Security benefits will help you. It is a statement about what you are physically or mentally capable of doing as it relates to work functioning.
As far as physical functioning, they look at seven main factors: sitting, standing, walking, lifting carrying, pushing, and pulling. There are many more factors that should be discussed with mental limitations in a medical source statement but the main ones are concentration, persistence and pace; understanding, remembering and applying information; interacting with others; and one’s ability to adopt or manage oneself.
The attorneys at The Good Law Group can help secure a victory in your social security disability claim!