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3 Reasons Your Doctor’s Opinion Might Not Help Your SSD Application

Submitting a doctor’s statement supporting their Social Security Disability (SSD) application is a step that many people think will ensure their claim is accepted. While it can certainly help your case, that document alone doesn’t prove eligibility. And it can be discouraging when you have a strong case – one supported by a medical expert familiar with your condition – and still be rejected.

The fact is, the Social Security Administration (SSA) sets a high bar for people applying for disability benefits. There are just as many reasons an application might be denied as accepted. Your doctor’s statement will be considered along with your medical history, work situation, and many other factors. Many people end up reapplying even if their treating physician made a strong initial case for eligibility.

What a Doctor’s Statement Provides

A doctor’s statement is intended to help the SSA understand the nature and severity of a person’s disability, as well as the expected duration of their condition. As part of the application process, your doctor will be asked how your condition limits your daily activities, what your tests show, and what treatments you have received. This process is useful in explaining how your disability prevents you from performing a specific job or maintaining employment.

If there is insufficient information to make a decision, the SSA might request additional medical information about your condition or ask you to attend a special examination.

So, why wouldn’t a doctor’s opinion help someone’s chance of approval?

1. Incomplete or Contradictory Medical Information

A statement that doesn’t align with other information in your claim probably won’t help your chances. But, even if your doctor provides an accurate report regarding your disability, many other factors could still outweigh the report. A failure to submit all of the required documentation will likely lead to a rejection, as will the perception that someone is not cooperating with the application process. A doctor’s opinion won’t be enough to offset an incomplete application, even if the disability is real.

Be sure to familiarize yourself with the main reasons for denial before submitting your application:

  • If your condition has improved to the point where the SSA considers you able to work.
  • A failure to show up to scheduled medical exams.
  • Giving false or misleading information in a previous application.

A history of denials might also raise an applicant’s risk of rejection. Again – these factors can change and don’t have to keep you from reapplying if you need assistance.

2. Failure to Follow Treatment

If a patient doesn’t follow the treatment prescribed by his doctor, that could cause his claim to be denied. The medical records submitted with an application play an important role in helping the SSA understand your medical history. If you opted out of prescribed therapies, the examiner might not be able to determine whether or not your disability prevents you from being able to work.

However, the doctor’s statement only gives part of the picture. There might be a valid reason for choosing not to follow a particular treatment plan. Your explanation should be included in your application, and if not, then introduced during the appeals process. The purpose of a consultative exam is to provide a more complete picture of your disability and the limitations it poses. Agreeing to attend might end up validating your reasons for opting out of something that wasn’t right for you.

3. Your Income or Work Situation

The SSA seeks to approve claims for people who are unable to work due to their disability. Therefore, your work situation is another factor that could cause your claim to be denied, even with a statement from a doctor affirming your disability.

While there are conditions under which you can collect benefits and continue working, several work-related factors can figure into a rejection of a claim:

  • If it is determined that you can work following vocational training.
  • If advances in your medical treatment enable you to work.
  • If it is determined that your medical condition doesn’t sufficiently affect the kind of work you do.

It’s important to understand the role that a physician’s opinion can play in the larger picture that your application presents. If you choose to appeal a claim, it might be in your best interest to have an SSD attorney represent you. An attorney familiar with the process can help you understand what information your physician can provide that will most support your claim.

To talk to a Social Security Disability lawyer who can help you better understand the role of your doctor’s statement, fill out our online form or call Walner Law at 480-508-8800 to schedule a free case evaluation.