STEP 1: Start with reality. Your doctor does not want to get involved.
Your doctor’s support in your social security disability case, though not required, is a big help. But unfortunately most doctors do not want to get involved. It’s not that they are bad people. Doctors want to heal, and supporting a disability claim is an admission that they have failed. Moreover, many think that once people get on disability they stop trying to get better. Most doctors have patients seeking disability that they really don’t think should be on disability. And let’s face it: doctors are busy, and already have too much paperwork, thanks to the government and the insurance industry. They are not excited to add to that burden by filling out forms or dictating a letter of support in your disability case.
STEP 2: Adjust your attitude. “Get over” the fact that your doctor will have to be “courted” to help you in your disability case.
You have been through a lot. Different and uncomfortable surgeries and procedures. Different medications, all with uniquely annoying side effects. It is understandable if you have at least a tiny bit of resentment toward your doctor. After all, she has not gotten you back to work and a normal life.
So isn’t helping you get social security disability benefits the least your doctor can do?. As we noted at step 1 above, however, she likely does not want to get involved. But it is very important that you put aside any resentment or frustration your treating doctor’s reluctance. Unchecked, that resentment may show through in this important conversation, driving a wedge between you and your doctor. In a word, at least for this doctor-patient encounter, get over it!
STEP 3: Make the “space” for a conversation with your doctor about your ability to work.
Your first goal is to have a conversation with your doctor about your disability, the problems you are continuing to have, and your ability to work. But first you need to be sure that she in the right “mood” for that conversation.
To understand your doctor you must first realize that, even if she truly wants to help you, she is feeling pressure to end your consultation and move on to the next patient. It’s just the reality of a busy medical practice. If, as your consultation is wrapping up, you tell your doctor that you want to talk about your disability, she will not fully receptive to that conversation. She will likely have one hand on the door knob, and doing her best to quickly end the conversation. You will likely find her answers unsatisfactory, and your pressing her for more information will further inflame her sense of being pressured.
Let your doctor decide when and how this important conversation happens. If she says “now” she is more open to a full conversation, since she agreed to it. If she wants to schedule a separate appointment, simply agree to that.
Either way you must give your Doctor control of how and when this discussion of your disability takes place.
STEP 4: Have a real doctor-patient conversation about your condition and ability to work.
The major problem I have seen is a disconnect between the doctor and their disability-seeking patients. The issue of disability is seldom discussed by doctor and patient, and most patients either really don’t know whether their doctor supports their claim for social security disability or wrongly believe their doctor does support their disability application. The point of this conversation is to get your doctor’s true opinion, not to persuade or convince her that you are disabled. Make it clear to your doctor that are seeking her opinion of your ability to do work-related activities.
STEP 5: Tell your doctor why you are considering or pursuing a disability claim. Then ask for your doctor’s opinion of your ability to work.
Be totally honest about your condition. If you and your doctor have been together for a while and have pursued different treatments and therapies, tell her in what ways you have improved under her care. People seldom see no improvement from medical treatment, and your doctor will be pleased her efforts have given you some benefit. Be precise about the areas of your work-related functioning (sitting, standing, walking, dealing with stress, pain, etc) that you think keep you from working.
Ask her precisely:
As my doctor, what is your opinion on my ability to work?
This might be the point at which your doctor starts being evasive. Obviously you could get a variety of different answers. Equally obvious is that your goal is to get a “YES” from your treating doctor – that she agrees you cannot work. If you get this kind of answer, skip to Step 8.
If you get a “no” answer (your doctor does not think you are disabled) I would recommend you remind her of the problems you have that you say keep you from working. See if you can persuade her, but keep you cool, and back off if you don’t get a more cooperative stance.
More than likely, though, you will get an answer that is evasive, and unclear like the following
“I don’t get involved with disability matters”
“You need a different kind of doctor’s opinion for disability”
STEP 6: Deal with “Objections”
Salesman are trained to deal with potential customer “objections”: the “ad hoc” reasons the potential customer says “no”. Unfortunately, you will likely be in the position of a salesman, dealing with your doctor’s “objections” as to why she cannot help you in your disability case. The two objections noted above seem to be the most frequent, designed to efficiently end the conversation abruptly. How could you argue with your doctor who says she does not do disability paperwork? She is a doctor, after all, and it is her medical practice. Shouldn’t she have the right to determine how she runs her practice?
And doesn’t it make sense that, since there are doctors and clinic that specialize in functionality (physiatrists), you should look to this type of doctor for your disability opinion?
These objections, however, ignore the fact that, under social security disability law, your treating doctor’s opinion, regardless of specialty, is important. Going to see a physiatrist to get a residual functional capacity evaluation will cost you yet more money you probably do not have. Moreover, a one-off doctor opinion does not get the respect from social security that an opinion from a treating doctor of long standing does.
But I do not suggest you try and educate your doctor about these finer points of disability law. Your goal is not to win a debate; it is to appeal to your doctor’s emotions. Instead, this is the best strategy:
Communicate to the doctor that your disability was denied because of the medical opinion of a government doctor who has never seen you. Only your opinion, dear doctor, will change that.
Now you have engaged both your doctor’s pride and her natural inclination to “protect” her patient. Some other, less qualified doctor who works for the government is contradicting her opinion. The only way for her to “defend her reputation” is to put her opinion in writing. Make it clear to her that her medical records are not sufficient, because they are not a medical opinion.
STEP 7: Make it clear HOW your doctor provides an opinion to social security.
Your goal is to secure written documentation of your doctor’s opinion of your ability to perform work-related activity. But DO NOT let your doctor simply “give you a letter”. Doctor’s do not know what social security needs, and will in all likelihood give you a terse, conclusory letter that will not win the day with social security.
Rather, you need for your doctor to complete a Medical Source Statement. If you have an attorney, this is something your attorney can provide to the doctor.
Your goal is to secure your doctor’s promise to complete a form that documents her opinion of your ability to perform work-related activity. Leave it to your attorney as to what that form will be.