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This particular page is for the use of physicians, who may be looking into the Social Security Disability system, either when they are considering performing examinations for the Disability Determination Services Bureau, or when a patient has asked them about a disability claim.
Doctors can contract with the Disability Determination Services Bureau (DDS) to perform examinations, particularly of their own patients. Click here to access information for medical professionals on the disability process.
If you have a patient who is seriously limited in his or her ability to work, you may wish to suggest that they at least consider filing for Social Security Disability, and perhaps contact the State of Iowa Vocational Rehabilitation Services to look into retraining. Your patient can talk to an attorney who specializes in Social Security Disability cases, at no charge. The Social Security Act regulates what attorneys who represent people before the Social Security Administration can charge for handling Social Security Disability or SSI cases. Generally, fees are limited to 25% of back benefits, in addition to any expenses incurred by the attorney. If the person is denied, the attorney can almost never charge for any services, other than expenses incurred in handling the case, such as medical records or medical opinions.
Particularly among patients who are over 55, unable to return to past work, and limited to light or sedentary work, the patient may have a reasonable chance to qualify. The same is true for younger individuals who are simply not able to return to competitive work. While a statement by a doctor that a particular patient just can’t work might be helpful, the Social Security Administration jealously guards its authority to make such determinations. The DDS will be more likely to defer to your medical judgment, in detail, that your patient is restricted in specific physical tasks, backed by medical tests or findings on examination.Click here for a printable form, in Adobe Acrobat format, detailing information such as:
Current diagnoses and medication
Walking, at one time and total in an 8-hour day, and the need to use a cane or to elevate the feet.
Carrying and lifting, occasionally (up to 1/3 of an 8-hour day) and frequently (up to 2/3 of an 8-hour day).
Standing, at one time and total in an 8-hour day.
Sitting, at one time and total in an 8-hour day.
Climbing stairs and ladders — how many, and how often
Problems using hands and arms
Elevating the feet (how many minutes or hours a day? Using a foot stool, horizontal, or feet above the heart?)
Need to lie down during the day (how often, and for how long — as well as any other needs, such as a dark and quiet room).
Side effects of medication, or depression, on the ability to be physically active, or the need for a psychological evaluation by DDS, to assess anxiety, depression, panic disorder, mental retardation, or other psychological issues.
Will your patient miss an average of two or more days of work a month, on average, due to a medically-diagnosed condition or combination of conditions?
CAUTION: Doctors should not just rely on the statements of the patient, but should make independent examination. Also, doctors often just ask those questions, without asking whether the capacity is less on some days. Very often, the patient will respond, “Yes, 5 days a week, I can’t do half that much.”
For a description of the definitions of various conditions, go to the Listings of Impairments, which are part of the regulations of the Social Security Administration. The Listings of Impairments are a set of definitions of particular diseases and disorders, such as epilepsy,MS, chronic heart failure, kidney disease, diabetes mellitus and a variety of other physical conditions. There are also a number of mental disorders, including mental retardation, depression, anxiety and other emotional and organic mental disorders. Many of the Listings are of sufficient specifics that an experienced physician may be able to work through a particular Listing, showing where the tests satisfy that Listing,
See also, a more general publication, Disability Evaluation Under Social Security — Medical criteria for evaluating Social Security disability claims. It is a collection of resources, which may be too involved for the casual reader. It includes the Listing of Impairments, among other resources.
For a Social Security Ruling setting out the process for evaluating medical evidence, see Social Security Ruling 96-8p. For a specific ruling, similar to the Listings, on Chronic Fatigue Syndrome, see SSR 99-2p. For the diagnostic criteria for CFS, see the Diagnostic Criteria for Chronic Fatigue Syndrome.
If you are asked about a patient’s capacity to handle benefits, or if you are concerned that a patient may be at risk handling their own benefits, you can complete a report,Physician/Medical Officer’s Statement of Patient’s Capability to Manage Benefits. You may be aware of specific health hazards of the patient handling his or her own benefits, including greater access to illegal drugs or alcohol, and the opinion of a treating physician will normally be accorded substantial weight. A letter setting out the reasons for your concern, accompanying the form, directed to the Social Security office, will likely get their attention.
For general medical searches, try Group Health Inc. and MedLinePlus; for workplace health issues, check out InteliHealth. For cancer links, go to the National Cancer Institute; for diabetes and digestive disorders, go to the National Institute of Diabetes & Digestive & Kidney Diseases. The American Lung Association, notes that occupational breathing problems are the number one source of breathing disorders in the United States.