BMN Blog

FEB 13
A Physician’s Insider Guide for Social Security Disability Cases

Physicians serve on the frontlines of our healthcare system, and by extension the many social programs guaranteed by the Social Security Administration. It’s a large responsibility and we owe them a debt of gratitude. These dedicated care providers, across many areas of practice and at varied levels within our medical system, help more than 57 million children and adults who live with disabilities across the United States.

Not only are physicians relied upon to provide sound medical advice and treatment options for patients with significant disabilities, the Social Security Administration also relies on care providers to furnish “objective” medical evidence to help decide whether someone qualifies for disability benefits.

That’s no small task given that more than 1 million Americans are currently waiting, often desperately, to see whether they qualify for assistance. What would one million people look like if we lined them up shoulder to shoulder? How many states would they cross? Would they reach the moon? And back? What’s more, for those who qualify there’s an average wait of nearly two years before they receive benefits; many die before the process is completed.

Policy makers and administrators know all too well that disability and poverty are closely related. Along with the physical and emotional limitations imposed by severe disabilities, most people living with disabilities face significant financial pressures, having extremely limited savings and other assets needed to survive. What’s more, the costs directly associated with having a disability such as out-of-pocket medical expenses, can be overwhelming.

Physicians do play a vital role in the health of the disability benefits process but are routinely asked to balance that need with the rigorous daily demands of the healthcare system. So how can physicians support the needs of disabled patients within the confines of an already busy schedule? What strategies are available for care providers to help reduce the burden of paperwork, yet still provide accurate information to the Social Security Administration so their patients can receive a fair evaluation?

Here are some tips:

  • Take a few moments to become familiar with the basic tenets of the Social Security disability programs. This will help you have a rough, working knowledge of what is available for your patients and the general process for obtaining disability benefits. Here’s a link to Answers for Doctors & Other Health Professionals published by the Social Security Administration.
  • Make sure your patient understands your role in the disability process. It is a complex system, and your role is to provide accurate information to support a fair evaluation. Patients need to understand that while physicians want to help, they cannot be held responsible for the disability approval process.
  • If you are aware that your patient is considering an application for disability benefits, ask them to provide you with a short and concise list of limitations in advance of their visit. The list should include specific ways the disability limits their daily life, including real-life examples.
  • Discuss the list of limitations honestly with your patient, providing up-front feedback for areas of disagreement or confusion. This will provide your patient with a realistic expectation of what you consider to be “objective” medical evidence that would be included in a report to the Social Security Administration.
  • Take a moment to reference the Social Security Administrations Physical Residual Functional Capacity Assessment form. This will help you understand the types of information gathered by the Social Security Administration to evaluate disability claims.
  • The Social Security Act is very complex and there are many exceptions to almost every rule. For help with the legal process, always recommend a qualified disability attorney for guidance. The advice is particularly important before a patient files their initial application.

FOR ADDITIONAL INFORMATION

Social Security has a very helpful website with a wealth of general information and downloadable PDFs on a multitude of subjects. The website also publishes a toll-free number for those who wish to speak with a live representative. I am personally aware that the wait times to get a live person on the phone can be very long and that the quality and accuracy of the information varies from one representative to another.

 www.ssa.gov

Please feel free to contact me for additional information or clarification. I can be reached via my website https://www.coxdisability.com or via email to jcox@coxdisability.com.

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