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What to do when Social Security Disability Insurance won’t pay because doctors can’t diagnose your disease

My doctor doesn't support my social security claims

Social Security disability benefits are available for people who have been working but become disabled and unable to work. If you are under 24 when you become disabled, you must have worked one and a half years during the three years before your disability began. For people over age 24, there must be a medical condition that is severe. The disability must be on is on the Social Security impairment list, the person must be unable to do any of their previous jobs, or be unable to any other job they qualify for. The disability must last, or expect to last, at least one year.

There are also benefits available for the spouse and child of a disabled worker. A spouse is eligible if he or she is at least 62, has a child under age 16 or a disabled child, or is divorced but was married to the worker for 10 years. Children (including adopted children or dependent stepchildren) of disabled workers are also eligible if they are under 18, under 19 and still in high school, or are adults who were disabled before age 22.

The most important thing, besides your medical eligibility, in getting your disability claims is your doctor's opinions. The SSA gives a lot of weight as to how your medical provider portrays your disability.

Having your doctor's claim is very crucial to winning your disability benefits. This is because the SSA takes into account what your doctor says to conclude the final decision. So, what do you do if your doctor doesn't cooperate or is unable to tell what's wrong?

Request a Consultative Examination

Even if you have your own doctor, a consultation or Consultative Examination, CE would need to be performed by the doctor recommended by the SSA. It is for this reason that CEs are not always cooperative to the claimants; however, if you do not feel comfortable with your CE, you can request a new one.

Mental illness. If mental illness is the sole basis of your claim, a psychological CE will likely be scheduled for you without having to request it. However, if you suffer from anxiety, depression, or other mental illness along with a physical condition, it may be helpful to request a psychological CE.

If a mental CE is scheduled for you, make sure you have submitted evidence that supports your allegation of mental illness. Although the CE should have been given your medical records, make sure that you bring copies of anything that may be relevant. This includes treatment notes and proof of prescriptions, and any other information that supports your claim. You should also be honest with the evaluator—this means that you should not minimize, or exaggerate, your symptoms.

Specialist. Sometimes your doctor will not help with your disability claim because he or she does not have the expertise to assess the full effects of your condition on your ability to work. In this case, a CE with a specialist could be helpful. This may be true in cases of low I.Q., for example, where a general practitioner is aware of the patient's disability but is unable to determine its extent. In this case, you can also request that the SSA administer an I.Q. test, in addition to an evaluation by a specialist.

An experienced disability attorney will be able to determine if a CE will help you with your claim, and to decide what kind of CE would best.

Find a New Doctor

If your doctor is hesitant to help you file the claim, you can request a new one. However, there are some pros and cons to it.

  • -Pros

The new doctor may be better at diagnosing your condition, may better understand how it affects you and may be better at understanding how disability works.

  • -Cons

Finding a new doctor may mean looking at your disease from scratch all over again. The new doctor might not be familiar with your situation and may have to perform all the tests again.

Beware of doctor shopping

If you do choose to consult a new doctor, you would need to assure the SSA that you are not 'doctor shopping'. The SSA would decide you are doctor shopping if you frequently change doctors in hopes of getting 'the' doctor who claims your opinions on your disability.

Know the doctor's reputation

Some people have a habit of being too helpful to about anyone. Similarly, some doctors have a reputation of helping any claimants regardless of the severity of their disease. The SSA won't give weightage to opinions of such doctors. So before you decide on your medical provider, be sure to take into account their reputation.

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Friday, 15 November 2019