After over a 1,000 successful Social Security Disability cases, as a disability lawyer I have found there is one report that can make a difference. What is that report?
First, the agency considers the opinion of the treating doctor to be the most important document in the medical file. However, the critical opinion often does not exist. Why is this? Simply, doctors are involved in treatment. They are not concerned with legal disability issues.
Second, the agency will not allow doctors to make the legal determination in the case. Thus, if the doctor says a claimant is “disabled” the agency will reject this “naked” statement. The agency will say this is a legal determination to be made by the Social Security Judge.
Third, a mere statement that you are “disabled” will not be accepted. However, an opinion (from the treating doctor) stating what impact the claimant's impairments have on important body functions can be extremely important and may be decisive in a case. For example, the doctor's opinion on how long the claimant can walk, stand or sit is critical. Also, the doctor's opinion regarding lifting, bending, etc. is critical.
Fourth, an experienced disability lawyer will have a set of evaluation forms for your doctor. They will be tailored for your individual impairment. For example, for a low back problem, there will be a lumbar spine form. This form will ask the doctor critical questions on how the low back problem impairs important body functions like walking, standing, sitting, lifting, bending, etc.
Fifth, unlike a “naked” statement of disability, this report will elicit what the doctor's opinion is about the claimant's ability to perform critical work activities. If the doctor's opinion in this matter is supported by the doctor's treatment records over a period of time, then the Social Security Judge may be compelled to give this report “great weight” in the claimant's case.
Sixth, even if other medical evidence disagrees with the treating doctor's opinion, the treating doctor's opinion will prevail if the opinion is well supported by the treating doctor's records.
In summary, a single report can win a Social Security Disability case. However, it has to fit the above criteria: (1) the doctor must be a treating doctor; (2) the opinion must indicate how critical body functions are affected by the impairment; (3) the opinion cannot just say the claimant is disabled; and (4) the doctor's opinion must be grounded in the doctor's treatment records. An experienced Social Security lawyer can work with the claimant's to develop this winning report.