Thursday, April 18, 2024

What Not To Tell A Disability Doctor

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What Should You Say If You Go To A Social Security Exam

How to Educate Your Doctor About Social Security Disability

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What To Expect During An Ime

During the independent medical exam, the doctor’s objective is to evaluate the extent of your work injury and pass off this information to the insurance company .

The workers’ comp doctor will be looking at your physical appearance and how you move:

  • How easily can you sit and stand?
  • Do you limp or groan in discomfort when you move?
  • Did you struggle to get in and out of your car in the parking lot?

The doctor will be looking very closely at physical signs of pain or discomfort or lack thereof.

During the IME your doctor will first ask you about your medical history, any pre-existing conditions, and any medical treatments you may have used in the past.

Be prepared to explain in detail how your work accident has affected your daily life and don’t try to downplay any details.

Remember, the doctor has you under close surveillance. They are looking for anything that suggests your condition is not as bad as you say.

For that reason, make sure to share accurate details that indicate how your quality of life has suffered from the accident.

If you decide you want to switch to another doctor , you can usually do so with a simple request. However, the insurance company will prefer the new doctor to be within its coverage network.

The most important thing you can do during your IME is to be honest. Insurance companies are skilled at finding inconsistencies in your statements and symptoms and will use those inconsistencies to destroy your workers’ comp claim.

Is It A Good Sign When The Ssa Sends You To A Doctor

Not everyone with a social security disability claim will be required to undergo aconsultative exam. Most of the time, the SSA will send you to a disability doctor if:

  • your medical evidence isnt enough to prove your disability
  • you have not seen your treating doctor for a long time
  • theres doubt that your condition is disabling enough to warrant a disability benefit

Also Check: How To Calculate Disability Retirement Pay

I Havent Been Going To The Doctor Because I Dont Think Their Recommended Treatment Will Work

Youve done two things with that statement:

  • First off, you have admitted to the judge that you are not treating a medical provider on a regular basis. The general assumption is if you are not treating by a doctor regularly you must not be that disabled.
  • The second thing you have done is admit that you are not following recommended treatment. A judge will take that statement and argue that if you had followed the prescribed treatment then you would not be disabled. Again, in a situation like this, you should talk it over with your attorney prior to the hearing to see how to handle your lack of medical treatment. There are better ways to approach the situation rather than saying you dont agree with what the doctor is saying. That, in and of itself, is not a good reason to not follow prescribed treatment. It goes a lot further with a judge if you follow every recommendation from your doctor and then say that none of it worked.
  • There Are Many Reasons Social Security Relies On These Doctors To Deny Your Case

    15 Things Not To Say To Disabled People
  • They give the appearance of a credible source to Social Security because it is someone they trust.
  • They are certified to be the eyes that will tell Social Security if you are disabled or not. Understand that your case worker is not a doctor so they rely on these doctors to tell them about your disability.
  • They are trained by Social Security to follow a protocol so that the examination is standardized in every case.
  • While that would be understandable to filter out fakers, the end result is that good people like you keep getting denied due to poor level examinations.

    Read Also: How Much Does California State Disability Pay

    Getting A Letter Of Support

  • 1Give your doctor a copy of your written limitations. Your written list can assist the doctor while they complete the letter or form. If you run out of time in your appointment, your doctor can read the list for more information.XResearch source
  • Insist that the doctor takes the letter. You might say, This copy is for you. I have this information.
  • 2Ask the doctor to provide as much evidence as possible. If the doctor does not provide any evidence of your condition, your claim may be rejected. X-rays, test results, medication history, or even dates of surgery can help prove that you have a long-standing condition. The doctor should also explain how your condition affects your ability to work.XResearch source
  • You can tell your doctor what type of evidence you need. You might say, To support my claim, they need as much information about my condition as possible. You should probably include the results of my bloodwork.
  • Your doctor should include any tests that have been done, what procedures or therapies you have gone through, what medications you have taken to manage your condition, and how long the condition is expected to last.
  • 4Remind the doctor periodically until you receive the letter. In many cases, the doctor will not fill out the form or letter during your visit, as there is not enough time. Call back after a week to see if the form is completed. If it is not, gently remind the office that you would like the form back soon.XResearch source
  • Educate Your Doctor About Your Disability Problem

    Let the doctor know you’ll be applying for Social Security disability, but don’t assume your doctor understands the Social Security disability process, which is a complex system. It takes other doctors working for Social Security years to fully understand federal medical policies. It is important to explain to the doctor that you are not requesting an opinion about whether you are disabled. This will be good news to your doctor, who is probably tired of receiving blame from patients about their disability claims sometimes being denied.

    You could say something like, “I know you don’t control the government’s disability decisions and I don’t even know if I qualify for disability. However, I need your help in getting accurate information to them so that I can receive a fair evaluation.” You will almost certainly receive a positive response to this statement. And then you can tell the doctor about how your impairments affect you.

    Don’t Miss: How To Increase Your Va Disability Rating

    The Doctor’s Opinion Should Be Based On Medical Records

    The SSA will review your medical records to see if there is any inconsistency with the doctor’s medical notes and his opinion of whether you are disabled. For instance, if the doctor opined that you were unable to stand for a majority of the workday, but all of his routine examinations of you were normal, then the SSA might reject the doctor’s medical opinion. Generally, an opinion by a treating doctor will be given strong weight by the SSA if the opinion is supported by the medical evidence in the doctor’s records and other medical records.

    If you have questions regarding how to obtain a medical source statement or what should be in it, you should consult with a disability attorney.

    Take our disability quiz to help you determine whether you qualify for benefits.

    What Is An Independent Medical Examination

    3 Things you should NOT ask your doctor to do if you have a disability – Disability Law Show: S3 E10

    An IME is a formal medical exam used to evaluate the extent of your workplace injury.

    Once the insurance company is notified of your claim request, they will request that you submit to an Independent Medical Examination .

    Independent medical exams are typically requested when:

    • The insurance company disagrees with your own doctor’s opinion
    • Negotiations with the claims adjuster are taking too long, or becoming too expensive
    • Your treating physician determines total or partial disability

    While insurance companies position this as a “request,” make no mistake: failure to submit to the IME will result in the denial of your workers’ compensation claim.

    This doctor administering the IME will be an expert on workers’ compensation cases and injuries. You can expect this doctor to be chosen for you by the insurance company.

    If your employer’s insurance company is required to compensate you for your workplace injury, then you can be sure they’ll do everything they can to limit the benefits payouts.

    The surest way to limit your workers’ comp is to have “proof” from your workers’ compensation doctor that you’re ready and fit to go back to work.

    The doctor’s evaluation will decide on any physical work restrictions, recommendations for time off work, or perhaps returning to work on light duty .

    Read Also: Va Disability Change Direct Deposit

    How Long Will It Take For Ssa To Pay Me

    As a rule, it takes one to two months for back benefits to be paid and monthly benefits to begin in a Social Security disability case in which no SSI application was ever filed.

    But these are only general rules. In some cases, it takes as long as 3 months for back benefits to be paid. When it takes more than 90 days for back benefits to be paid in a Social Security disability case, it may mean that there has been a bureaucratic mix-up somewhere in the system. In that case it will be necessary to take some sort of action to deal with the delayed benefits.

    If 90 days pass from the date of the decision and I am still not paid my back benefits, is there anything that can be done to speed up payment?

    It is possible that your attorney may be able to do something if you are not paid after 90 days. Be sure to telephone your attorney to explain that you havent gotten paid after about three months. It may be necessary at that point to contact the payment center.

    Important Information For You To Submit For Your Claim

    If you have a very severe illness or injury listed in the Social Securitys Listings and you submit records to document your diagnosis and the severity of your condition, you may be approved at Step Four of the disability evaluation process. If you dont meet the Listings, you have another opportunity to be approved for benefits. At that point, Step Five in the evaluation, information about your work history and education become very important.

    You are more likely to be successful with your Social Security claim if you know how the Social Security Administration evaluates for disability. With that knowledge, you will recognize the information you need to provide to support your claim.

    Also Check: Nolo Social Security Disability

    Worried About What To Tell Your Doctor Talk To A Workers Compensation Attorney First

    After a work accident, consult a workers comp lawyer for legal advice about what to say to your medical provider before you begin navigating the workers compensation system.

    Our law firm has handled hundreds of cases just like yours, and we can help you develop the right language to use so that you are honest but thorough with your treating doctor.

    Explore our resources if you would like more information. You can also call to set up a free consultation with a workers comp attorney to discuss your case.

    Who Decides If I Am Disabled If Both My Doctor And The Social Security Disability Doctors Say I Am Unable To Work Will I Be Approved

    Download What Your Doctor May Not Tell You About ...

    Claims examiners in consultation with a physician decide whether you are disabled according to Social Security Disability rules. These employees of the Disability Determining Services called DDS for short, make the disability decision because they are trained in Social Security law and regulations including Social Securitys specific definition of disability. Neither your own doctors nor a doctor you might see in a consultative examination make the decision. If your claim has progressed to a hearing appeal, the administrative law judge who hears your case makes the decision.

    Read Also: Sdi Benefits Calculator

    Exams Will Vary By Doctor But It’s Generally A Good Idea To Be Wary During A Medical Exam For Social Security

    Updated By Bethany K. Laurence, Attorney

    What is usually meant by “Social Security disability doctor” is a doctor who is hired to do a consultative exam for Social Security. These doctors are not employees of the Social Security Administration, but independent doctors in private practice who are trying to make a bit of extra money. Should you trust this consulting doctor? The answer is no. As a former disability examiner, I have been on the receiving end in multiple capacities. First, I have heard many hundreds of complaints voiced by claimants as to how they were treated by the doctor who conducted their exam .

    Second, I have read hundreds of consultative exam reports written by doctors who have indicated observations such as the following:

    • “Patient stated he felt fine and free of pain.”
    • “Patient had no difficulty getting onto examination table.”
    • “Patient used cane in office, but did not use cane while walking to his car.”

    Third, you should understand why disability claims examiners send claimants to consultative medical exams. The most common reason is that they don’t think you are disabled but they need recent medical evidence in order to deny you disability benefits. Claimants are often sent to just to have a symptom checked or one test done, such as a straight-leg test. For instance, if a straight-leg test comes back negative and a positive test is required for a disability listing, you can be denied.

    Explain Whether You Meet Or Equal A Listing

    You should ask your doctor or psychologist to comment on whether your medical conditions meet or “equal” the requirements of a disability “listing” that’s relevant to your impairment. For instance, if you have poor hearing, you might meet Social Security’s listing for “hearing loss.” Social Security’s disability listings are found in its Blue Book. Most doctors will need to be given a copy of the particular disability listing for reference.

    Recommended Reading: How To Calculate Disability Retirement Pay

    Will I Lose My Disability Benefits If I Inherit Money

    Social Security Disability, like Social Security, is not a means tested program. Therefore, your Social Security Disability benefits will not be affected by any change in your assets or your income. Furthermore, receiving an inheritance will not have any effect on your monthly Social Security Disability benefits.

    I Dont Know Why Im Here I Can Work

    Why won’t my doctor fill out forms saying I am disabled?

    This may sound like a crazy answer, but several of my clients have said this exact statement during their hearings. At no point during the representation did the client say to me they think they can work full time. And frankly, I ask all of my clients point-blank why they are applying for disability and whether they could work full-time if they were given a job with fewer work requirements. If at any point the client says to me they think they can work full-time then we simply withdraw their application. No harm no foul. So I give my clients plenty of opportunities throughout the process to tell me if they can work.

  • The reason many clients at the hearing say they think they can work is that they feel intimidated by the process. They hear the evidence and draw their own conclusions. This is dangerous because there are a lot of legal factors that go into finding a disability. You may think that you can work, but can you actually perform the job on a regular and consistent basis, 40 hours a week for 52 weeks a year? When put in those terms the answer tends to be a bit different.
  • A third reason why people may say they think they can work is that frankly, they are embarrassed. Applying for disability benefits is nothing to be embarrassed about.
  • The program is there to help you when you need to focus on your health. I always tell my clients to remember that everything in the hearing is confidential.

    Also Check: How Much Does Disability Pay In California

    Dont Rely On Social Security Doctors If You Are Not Seeing Your Own Doctors

    We just talked about how despite your own doctors assessments of disability, you were denied because some Social Security doctor, who only saw you once, says you are not disabled.

    Can you imagine what would happen if you were not seeing any doctors or the wrong doctors?

    You are right if you said a guaranteed denial.

    If you have been keeping up with my blog you know I talk about medical treatment and medical records like a broken record.

    If you want to learn more about improving your medical records take a look at my posts about the importance of medical records. Also, check my post about fixing your medical records to win your claim.

    The point of all this is that you want your own doctors and you want to go to the right doctors.

    Lack Of Hard Medical Evidence

    Many Social Security Disability claims are denied due to a lack of solid medical evidence. If you want to qualify for disability benefits you will need to prove that you are unable to work due to your disabling condition.

    In order to succeed in this, you must have medical records that show your disability has interfered with your ability to perform work activity.

    For example, you may be seeing your doctor every month for severe back pain but if your doctor has not documented how that back pain interferes with your ability to work, your claim for Social Security Disability may be denied.

    Many people assume that Social Security will send them to doctors who will gather the evidence needed to qualify and approve a claim for Social Security Disability benefits. This isn’t the case. Even if you are sent for medical exam by the Social Security office, it may not be enough to prove your disability.

    The medical records kept by your primary care physicians are what will be most important in determining the success of your claim for Social Security Disability benefits. Because of this, it is very important that you discuss how your disability is impacting your work life with your physician.

    Doctor’s notes excusing you from work or records suggesting a modified work schedule should be included with your medical files if possible. If you were working prior to filing for disability and had to miss time from work due to the disability, keep record of just how much time was lost.

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