The Secret to Winning Your Disability Case

Do you want to know the most important secret about winning Social Security Disability benefits?

It is not enough to say you are “disabled.” It is not even enough to have your doctor say you are “disabled.” In the final analysis, the term “disabled” in itself doesn’t really mean much to the Social Security Administration (SSA).

You have to prove that your medical condition (or combination of conditions) prevents you from sustaining a job. The SSA relies on accurate and complete medical records from doctors, clinics, and hospitals to determine how severe a physical or mental condition is.

“The importance of medical records in Social Security Disability cases is paramount,” says Nash Disability Law attorney Lawrence Mabes. “We work with our clients to get the right information and best explanation of their symptoms and limitations from their medical providers. Social Security has strict rules and regulations for disability claims. It takes a combined effort of your disability attorney vigorously advocating on your behalf and information from you and your doctors to win a disability claim.”

If you are applying for the first time for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits or are appealing an SSA denial of benefits, here are some essential facts you need to know about medical records.

What medical evidence is required by Social Security?

For a Social Security Disability case, medical evidence takes many forms, including bloodwork panels; imaging studies like MRIs, CAT scans, and X-rays; physician examination and treatment notes; and mental health records.

You will need up-to-date medical records to show the current state of your condition, and how the condition has progressed.

It is also critical to outline your treatment history. The SSA wants to know what treatments you have been given and how your condition(s) have responded to those medical treatments. In some cases, the SSA will deny your claim if you do not comply with prescribed treatment.

What is an RFC form?

To prove that your disorder prevents you from maintaining full-time employment, you must start with a diagnosis through a doctor’s exam. But a diagnosis alone is usually not enough to qualify you for benefits.

Your doctor should also explain how the symptoms of your medical conditions limit your ability to work. This is usually done using a form called the “Residual Functional Capacity” (RFC) form. The RFC form is separate from your medical records and helps your doctor explain your limitations.

Simply stated, an RFC is an evaluation of what you can still do despite your impairment(s). If, considering your age, education, and work experience, your condition causes limitations that prevent you from performing any work activity, you may qualify for benefits.

Your own treating doctor’s opinion about your RFC is one of the most important pieces of evidence in a Social Security Disability case.

Social Security often gives substantial weight to the opinion of your personal physician because that person has first-hand knowledge of your medical condition and is typically in a better and more informed position to provide information on what you can and cannot do.

If your physician submits his or her medical opinion supported by a comprehensive opinion about your RFC that is consistent with the medical evidence, you have a much stronger case and a much-improved chance of being awarded disability benefits.

The statement from your doctor must be specific and explain your limitations. It can be a form or a detailed letter. Statements that just say you are disabled, or unable to work, or only have a specific walking or lifting restriction, are generally not enough.

Why do I need an opinion from my doctor if Social Security has my medical records?

“You may think ‘Why do I need an opinion from my doctor, if the medical evidence is strong?’ It’s a good question, and one we are often asked by doctors themselves,” says Mabes. “The simple answer here is that adjudicators and administrative law judges who decide disability cases are not doctors. They cannot easily interpret the symptoms and test results in your medical records and develop a clear picture of how severely your condition(s) may restrict your daily activities including your ability to work. Medical records alone rarely make those connections. The doctor’s opinion will help bridge that gap for the judge.”

Okay, I see the importance of good medical documentation. How can I help win my case?

“First, I think something that is very beneficial for our disability lawyers is when we obtain the most accurate information possible about where you see your doctors,” Mabes explains. “Some clients may say ‘the doctor over on Western Avenue,’ and I wish that were good enough, but it’s not. The more specific information you give us, the better chance we have at obtaining your very important medical records. Also, if your medical treatment changes, tell us right away. There is no supercomputer with your medical record information that can be obtained by entering in your name or Social Security number. Unless you tell your disability attorney exactly where you see the doctor, we don’t know.”

“And second, carefully read and follow the guidance we give you over the phone and in our update emails. This advice is all to benefit you. As part of our comprehensive client support, Nash Disability Law regularly will send you emails with direction, advice and encouragement as we navigate the complex path to disability benefits. Helping us get the specific information you will need from your doctor—as spelled out in the emails—is going to help you win your case.”

At Nash Disability Law, we have a team of skilled and knowledgeable Chicago disability lawyers who will work on your case, and prepare you for your hearing. But that team becomes even stronger when you do your part.

Our disability lawyers are your Chicagoland go-to experts on Social Security Disability law.

Contact us for a free evaluation of your disability case and to learn more strategies to help you win the disability benefits you have rightfully earned.

According to a Government Accountability Office study, you are nearly 3 times more likely to be awarded disability benefits if you have a representative such as a disability attorney who will fight for your rights than if you have no representation at all.