SSI/SSDI Process: Doctors are doctors, lawyers are lawyers

One issue that often arises for SSDI advocates and claimants is unsupportive doctors. Most advocates will find out a doctor’s level of support for a patient’s case as a matter of course throughout the claim process either through medical records, procuring a medical source statement, a conversation with the doctor, or a combination of the above. Generally, doctors will be mostly supportive of a claim, however, some doctors are skeptical at best.

Potentially the most significant manner in which this issue manifests itself has nothing to do with a claimant, but the decision to apply itself. Similar to this example, many physicians seem to be inherently distrustful of the SSI/SSDI system. So, when doctors are asked by their patients if they should apply for disability many times the answer is a firm “no.” The question is, should it be? Wouldn’t the better answer be, “it’s your choice”?

The AMA’s Journal of Ethics states that the majority of doctors will encounter a disability claim at one point in their careers or another and will be given substantial influence over the outcome. This is because physicians’ records will be given substantial or controlling weight depending upon the patient’s relationship to the doctor, the doctor’s specialty, and the completeness of the doctor’s evaluation(s), among other considerations.

So, why, when he or she has so much control over the outcome of a case, would a doctor be uncomfortable in suggesting that a person apply for disability?

One reason appears to be that, due to repeated exposure to the SSDI and SSI systems doctors have seen some “bizarre and inequitable awards,” or generally view some of their patients as “gaming the system.” In the case that caused that article’s author, Dr. Mokotoff, to use such strong language, his patient suffered from hepatitis C. He goes on to point out that his patient was not, at the time, dying from hepatitis C.  This was something that Dr. Mokotoff, a cardiologist, became quite familiar with because, sadly, his wife passed away from the condition.

However, buried in the doctor’s words and the manner in which he seems to relate to disability is evidence that he does not understand that the SSDI and SSI systems are not just for people suffering from end-stage diseases. He goes on to say that he has seen many people awarded benefits who appeared to be healthy middle-aged individuals seemingly capable of holding down jobs. As well he should. Many people with cardiac conditions do not visibly appear to have a heart problem, but it is highly likely that the doctor encountered at least one patient that was awarded benefits who did not appear to be on death’s door at the time of the award, and whom the doctor would have agreed deserved the benefits.

Lack of understanding of the disability process or its qualification criteria is probably one of the most common issues advocates face when trying to work with doctors. While they are free to express their opinions, doctors like Dr. Mokotoff might not have considered the AMA’s stance that, “It is important that [doctors] understand and feel comfortable with the implications of diagnoses and other professional actions that have wider repercussions, particularly legal ones, for their patients.”

Overcoming erroneous negative comments or opinions expressed by medical professionals in your disability case is another way in which a skilled advocate can help you win your case.

If you would like to learn more about how advocates and doctors interact or are interested in disability services please contact us today.