How we win your disability case: Strong medical evidence

Transcript

David, one of the things that’s often confusing is that somebody can be disabled but not get Social Security disability benefits. It seems like the reason is you have to meet the Social Security regulations to get disability. That’s a good point. And when it comes to Social Security’s regulations that can kind of be accessed to maneuver, navigate through, well can start with medical treatment.

Medical treatment is very important, and medical treatment can be the linchpin to a disability case. We’ll work with our clients to obtain medical evidence. We’ll also work with our clients to obtain opinion evidence. There’s a big difference when it comes to objective medical evidence and opinion evidence. In order to get a sound opinion from a medical provider that Social Security will accept, there has to be underlying medical evidence to support that provider.

One of the things I’ve heard about that we often get is what’s called an RFC. What is that? An RFC is a residual functional capacity form. We also call it a medical source statement form. That is something that we will write a medical provider and obtain. That’s what we call opinion evidence.

If we’re talking about a physical impairment, the RFC will discuss or ask questions about your ability to sit, stand, lift, carry, walk if you suffer from pain that might force you to take extra breaks throughout the workday or might diminish your ability to maintain concentration or focus or even miss work.

And again, opinion evidence can be crucial to a disability case provided that we have the objective evidence to support it. Why is important if I have an RFC or Medical Source statement that says that I am limited and very limited in what I can do, why is it important that I still go see a doctor once I get a statement that says they have these limitations?

That kind of goes back to the need for objective medical evidence. If we just have a statement from a doctor or a form that’s completed by the doctor, and our client has only been there one time, most likely Social Security is not going to give it as much weight or consideration compared to an opinion from a medical provider that our client has been to numerous times, has also been sent out for testing, maybe referred to specialists.

That can be especially important for continuity of treatment. As a person applying for disability, what’s important information to give to my doctor? That is a great question. And communication is extremely important. One thing that I found over the past 23 years practicing Social Security law is that many times clients who are suffering from medical conditions get used to their own sense of normalcy.

What’s normal, what’s their baseline? And their baseline is not what you and I would consider normal or would consider. Okay. But what happens is that many times our clients will go to see their doctor during the exam. They may be asked, how are you doing? How are things going?

Doing? And the answer is, okay. I’m sure that you’ve seen many medical records where a client is asked, how are you doing? Or it’s reported in the report, okay, not in any distress, things like that, or even doing well, because the client says, I’m walking, I’m talking, and I’m here.

I’m doing well. Day is a good day. Exactly. And many times what’s lost in that is the fact that our client has experienced panic attacks on a daily basis or they experience pain or discomfort to the point to where they’re unable to get out of bed or they’re unable to kind of carry out their daily routine, their daily activities.

One thing that I know you do and I do, we suggest that our clients keep maybe a medical journal or a log, especially when we’re dealing with conditions like migraine headaches, anything that might have a flare up, seizure disorders, good days and bad days, panic attacks, anxiety attacks. It is crucial that your medical provider is aware of how severe your symptoms are and that they’re just not putting into that report, hey, you’re doing great, not reporting any problems, because what happens?

Social Security will look at those records and basically make a determination. Well, there’s not much here. We can’t find any evidence of disability. It sounds like it’s important for the client to give the doctor a picture of how life is over a period of time, not just the specific point in time when you’re in the doctor’s office.

Because Social Security is about what efforts you can sustain over a workday. 8 hours a day, five days a week, 50 weeks a year. Not heroic efforts of going to the doctor or heroic efforts of being at a hearing, but how you can get along on an ongoing basis.

And communication is key. It’s important that our clients convey to their medical providers what they deal with, not just when they’re sitting there in the exam room, but what they deal with on a daily, a weekly, or even a monthly basis, because that can go to the issue of sustainability.

Many times I have clients that might say, hey, I feel great a couple days out of the month, maybe a couple days out of the week, but on other days, I feel terrible. I’m in the bed. I can’t really do anything. And it’s important that we establish that through medical records, through opinion evidence, through the RFC forms that we were discussing to be able to demonstrate that our clients are unable to sustain gainful activity.

That goes back to the rules and regulations that you were talking about. Right. And the illustration is I have clients who come to us with a doctor’s letter that just says, my client’s disabled and can’t work. And the client says, well, why isn’t that sufficient? And the problem is that the issue of whether or not somebody is disabled, whether or not they can work, is an issue left up to the.

The judge himself. And what we need is the doctor to indicate what the limitations are, what the person can and can do. What you were talking about earlier, about sit, stand, walk, how often you can go to work, whether you need breaks or not, time off, those limitations are what need to be addressed by the doctor, not just the issue of our statement.

The patient is disabled, are not disabled. And I think one thing is important that we do here at Joyce and Barry is that we tailor those medical source statements. We don’t just send canned statements out asking basic or generic questions. I know you do the same thing. You’ll take a client’s case, you’ll look at the medical records, you’ll look at the conditions, you’ll look to see if there’s any particular limitations that might apply, and you’ll tailor that medical source statement to that particular case.

Yeah, the point here is we know what questions need to be asked. The doctor. Social Security knows that, too. But they don’t ask questions. They just get the medical records. What we do is calm through those records, talk to our clients, decide where the issues are, decide where the limitations are, and then, as you said, we tailor those questions that we ask the doctor to that particular person’s difficulties and to their limitations, so we get good evidence of whether they meet the regulations or not.

And what we do is, as we develop that evidence, we submit that evidence to the Social Security Administration. Many times, the evidence and the opinion evidence can be extremely helpful at the hearing level.