Why Can’t My Doctor Just Decide if I’m Disabled or Not?

Parmele Law FirmSocial Security

Wouldn’t it be nice if sometimes, just sometimes, things were easy? Take Social Security Disability Insurance (“SSDI” or “disability benefits”) for example. Wouldn’t it be nice if all you had to do to qualify for benefits was to just have your treating physician say you were disabled?

Maybe. But that’s not how it works.

Disability and Social Security Administration.

To be eligible to receive government benefits in the form of disability benefits, you must first meet the Social Security Administration’s (“SSA”) requirements. While a lot of things go into proving each eligibility requirement, there really are only two basic requirements:

  1. You need to meet the SSA’s definition of “total disability,” and
  2. You must have worked long enough— at least 5 out of the last 10 years if you are under 50; for those over 50 the years vary— at jobs where you paid Federal Insurance Contributions Act (“FICA”) premiums.

Let’s say you have all the work requirements you need. What about the medical side of things? What do you need to be eligible for disability benefits?

Well, first and foremost you must meet the SSA’s definition of “total disability.”  The SSA defines “total disability” as being unable to “…engage in any substantial gainful activity (SGA) because of a medically-determinable physical or mental impairment(s) that  is expected to result in death, or that has lasted or is expected to last for a continuous period of at least 12 months.”

Essentially, what the SSA’s definition means is that to be “totally disabled,” you must be completely unable to perform any work that you have ever done in the past, or any work similar to what you did in the past, or, anything— even a simple desk job.

Treating Physicians and Proof of Disability.

Ok, so the SSA has a pretty specific (and tough) definition of “totally disabled.” But why can’t you just present a note from your doctor saying that you are “totally disabled” or that you are “completely unable to perform” your past job or any other job because of your conditions?

Because the SSA wants objective, comprehensive medical evidence that there are specific functional restrictions that prevent you from returning to work. A note from your doctor saying that you are disabled is not specific enough. It does not tell the SSA exactly how your condition(s) limit you in your ability to perform the tasks required at your past job, or a similar job or any other type of job. The SSA is looking for objective medical evidence (test results, X-rays, etc.) that tells them things like:

  • how long you can stand, walk, or sit
  • how much weight you can lift, push, or pull
  • whether you can reach overhead, bend, or stoop
  • whether you can handle small object with your fingers or type
  • how frequently you need to take breaks, and
  • how much time you need to take off work for sick days or hospitalizations.

The medical evidence that the SSA is looking for is not just a diagnosis, but proof of functional limitations that keep you from working.

While a doctor’s note wont’ do it, doctors can provide this type of information in a Residual Functional Capacity form (“RFC”) that you can submit to the SSA to prove your claim.

It may not be easy to be awarded disability benefits, but that does not mean you should not consider it if it is appropriate for you.

Experienced Disability Attorneys.

If you are considering applying for benefits or have been denied benefits, call us. At Parmele Law Firm, getting people the disability benefits they deserve is what we do. We have offices in Poplar Bluff, Rolla, St. Louis, St. Joseph, West Plains and other cities in Missouri, and in Overland Park, Salina, Topeka, and Wichita Kansas; as well as in Illinois, and Oklahoma. We offer free consultations and we do not get paid unless you win your case. Call us at 855-727-8625 or send us an e-mail today to set up your free appointment.