Getting Your Doctor's Opinion Into Your Social Security Disability File and Making it Count

Having a detailed report on your symptoms and limitations from your doctor can make or break your disability case.

By , J.D. University of Virginia School of Law
Updated by Diana Chaikin, Attorney Seattle University School of Law
Updated 2/12/2024

Having a persuasive doctor's letter about your medical limitations can make or break your Social Security disability case. The Social Security Administration (SSA) often relies on doctors' opinions to help decide whether a disability applicant meets the requirements of a listed impairment or has the residual functional capacity to do full-time work.

Not all doctors' letters are persuasive, however. Social Security can't disregard a treating doctor's opinion, but the agency can give it less legal weight if it's inconsistent with the rest of your medical record or doesn't describe your symptoms in enough detail. The length and frequency of your treatment history, as well as your doctor's credentials, are also considered.

Can My Doctor Put Me on Disability?

Doctor's opinions are important whether you're seeking state short-term disability, have a private long-term disability insurance policy, or are applying for Social Security disability benefits. But neither government programs nor private insurers will accept a doctor's letter without question as the sole basis for paying out benefits. You'll need to establish that your doctor has the appropriate credentials and that the opinion is supported by medical evidence.

Your Doctor Must Be an Acceptable Medical Source

An acceptable medical source (AMS) is a health care provider who has the authority, education, and knowledge to interpret medical evidence. An AMS is defined by Social Security as a medical provider who can provide evidence to establish the existence of a "medically determinable impairment." A medically determinable impairment is one that results from "anatomical, physiological, or psychological abnormalities" that can be shown by "medically acceptable clinical and laboratory diagnostic techniques."

Social Security reviews everything that you submit for your case, but they don't have to take into consideration medical evidence that isn't from acceptable medical sources. The agency must explain in its decisions how the agency considered the persuasiveness of a medical provider's opinion when the provider is an AMS.

Acceptable medical sources include:

  • licensed medical or osteopathic doctors
  • licensed or certified psychologists
  • school psychologists (guidance counselors), but only for impairments involving intellectual disorder, learning disabilities, and borderline intellectual functioning
  • licensed optometrists for visual disorders
  • licensed podiatrists, for foot (or foot and ankle) impairments only, depending on the state
  • qualified speech language pathologists, for speech or language impairments only
  • licensed physician assistants
  • advanced registered nurse practitioners (ARNPs) or advanced practice registered nurses (APRNs), and
  • licensed audiologists, for hearing and balance disorders.

Physician assistants, nurse practitioners, and audiologists were added to the list of acceptable medical sources on March 27, 2017, so if your disability application was filed before that date, they won't be considered acceptable medical sources for your claim.

If your treating provider (such as a registered nurse or chiropractor) isn't an acceptable medical source, Social Security can't give weight to their medical opinion about your diagnosis and prognosis, but the agency can still use the provider's notes to help determine how severe your condition is. For example, the SSA will disregard a letter from a chiropractor that says you meet the listing criteria for degenerative disc disease, but can limit you to sit-down jobs based on the chiropractor's observations about your range of motion.

What Your Doctor's Letter Should Contain

Social Security called any letter or opinion from a doctor a "medical source statement." Unless your medical source statement describes your diagnosis, symptoms, treatment history, and limitations, then your doctor's opinion may not be persuasive. A letter from your doctor simply stating that you're disabled isn't going to cut it.

When writing their medical source statement, your doctor should refer to the medical tests or clinical notes that support their opinion. If there's evidence in your file that doesn't support your doctor's opinion, they should acknowledge the evidence and explain how they accounted for it in their opinion.

Your doctor's letter should also discuss 1) whether you meet a disability listing—a class of conditions that Social Security considers especially serious—and 2) your functional limitations. Make sure your doctor's letter includes the maximum amount of weight you can lift; how long you can sit, stand, and walk; and whether you must avoid other movements (such as bending or typing). If your disabling condition is related to your mental health, the letter should discuss how well you can remember instructions, concentrate on tasks, and get along with coworkers.

Finally, your medical source statement should indicate how effective your treatments have been in relieving your symptoms. Any side effects you have as a result of medications should be included, especially if they would have an impact on your functioning at work. For example, if you're taking medication for high blood pressure that makes you drowsy, the SSA needs to know.

Treating Doctors' Opinions Are More Persuasive

Social Security usually gives more weight to medical source statements from your treating doctor—the physician or psychologist who sees you regularly. Prior to 2017, the SSA was especially deferential to statements from treating doctors, frequently giving them "controlling weight" and adopting the doctor's opinion as the agency's own.

Since March 27, 2017, however, all medical source statements, including from Social Security's consulative examiners, are evaluated based on how well they're supported by and consistent with the medical record as a whole. But the SSA can still consider factors such as how long and how often you've seen your treating doctor when determining how persuasive the doctor's medical source statement is.

Opinions Must Be Well Supported by the Medical Record

"Well-supported" means that the doctor's opinion is backed up by objective medical evidence, such as lab tests, MRIs, or exam results, and observable medical signs (such as the results of a straight-leg test). For example, if you have an X-ray showing severe arthritis in your hands and your doctor says that you can only occasionally use your hands to pick up small objects, Social Security will likely find that opinion well-supported. But if your X-rays don't show anything wrong and your doctor says you can't use your hands at all, the agency probably won't take the doctor's opinion very seriously.

Opinions Must Be Consistent With the Medical Record

"Consistent" means that the opinion isn't an outlier among the evidence, including other medical opinions and your own statements. For example, if you're seeing several providers for treatment of PTSD—including group therapy, individual counseling sessions, and medication management—a letter from your psychologist stating that you aren't able to interact appropriately with coworkers is likely consistent with the medical record. But if your clinical notes indicate that you have an active social life with minimal PTSD symptoms, Social Security will probably find that the psychologist's opinion isn't consistent with the record.

Or, as another example, if a physician offers an opinion that you can sit in a chair for only 30 minutes at a time, but you report sitting on the sofa and watching movies on a regular basis, this could be seen as inconsistent. If there's an innocent explanation for this apparent inconsistencyfor example, you stand up or lie down every half hourthe doctor should explain this in their opinion.

When the Doctor's Expertise and Length of Treating Relationship Matter

While Social Security no longer formally addresses the frequency of your doctors' visits (your "longitudinal history"), the agency can find opinions from doctors more persuasive the longer and more involved they are in your treatment. An statement from a doctor who you've seen every month for the past ten years is probably going to be more convincing to the SSA than one from a doctor who you've seen only several times.

The medical provider's understanding of Social Security policy will also be considered, a factor that's likely to weigh in favor of Social Security's consultative examiners.

Opinions from doctors who specialize in the area of medicine dealing with your impairment are also generally more persuasive than those who aren't. For example, having your gastroenterologist (a doctor who focuses on digestive problems) write a statement about your limitations from a traumatic brain injury wouldn't have as much sway as a neurologist might.

Keep in mind that your doctor's area of expertise and treatment relationship aren't as important for a medical opinion as being supported and consistent with the record. But these factors can be the "cherry on top" for your disability application, as having a good treating specialist's opinion in the file typically strengthens your case.

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