“But my doctor said I’m disabled, isn’t that enough?”

In a word, “No”. Since SSA defines what disability is, it is up to them to determine whether or not an applicant for disability benefits is entitled to receive them under SSA’s definition of “disability”.

This does not mean that your doctor’s opinions are given no weight. In fact, SSA will give them controlling weight as long as there are subjective findings such as tests and labs, which support the doctors’ opinions.

Sometimes SSA will send a claimant to an independent, consulting doctor for an evaluation if they feel additional information is needed to decide a claim. These doctor’s opinions are also weighed by the decision maker, but they too are not determinative of whether or not you will get disability benefits.

The same is true for other agencies’ decisions regarding your limitations and disability. Worker’s compensation uses different guidelines, so their opinions are factored in, but will not guarantee or prevent you from getting disability benefits.

One entity that SSA does give the most deference to is the Veteran’s administration. This is because the VA rules regarding assessing disability is very similar to that used by SSA. An impairment rating by the VA that has you disabled and unemployable, whether service connected or not, is the most likely source to be deferred to by SSA.

The final source of evidence used to determine your disability is you. SSA will send questionnaires, read your medical records for your complaints and activities, and take testimony at hearing to determine whether or not you are disabled. Your credibility is very important. If you doctor reports you went on vacation, and you report that you cannot leave your bed, all of your complaints about pain and limitations will be given very little weight. It is important to tell SSA the entire truth, as well as making sure that your doctors have a good picture of where you are at during each visit. Telling your doctor you are fine when you are not will hurt your case. Everyone has good and bad days, that is understood, just make sure you let your providers and SSA know how many you have of each and what the difference between the two is.
Jennifer Scherf-Cook

* Additional information can be found online at www.socialsecurityjustice.com