Disabled boy in walker in front of playground

Documenting disablement with an Illinois disability lawyer

Social Security Disability claim decisions are often made based on the strength of the supporting medical evidence. A recent Social Security Administration report indicates nearly one-quarter of 2010 SSD claims were denied for medical reasons. As any Illinois disability lawyer can attest, people seeking SSD benefits must provide convincing, credible medical evidence. To be considered credible, some of this evidence must come from “acceptable medical sources.”

Defining acceptable sources

The SSA requires evidence from acceptable medical sources to establish the existence of a disabling condition. The SSA views licensed optometrists, podiatrists and physicians as sources that are qualified to diagnose conditions within their disciplines. The SSA also recognizes licensed psychologists, certified psychologists and speech-language pathologists with appropriate credentials as acceptable medical sources.

Evidence from other medical sources cannot be used to prove a disabling condition exists. However, as any Illinois disability lawyer can verify, this evidence still plays a role in the claim process. Objective tests and statements from other sources can support a diagnosis or offer insight into the disabling condition.

The SSA prefers evidence from sources with a history of treating the applicant. Once a disabling condition is established, evidence from a treating source can help establish the severity, symptoms and prognosis.

Consultative exams

If a claimant’s medical sources provide incomplete information, the SSA may use its own medical sources to secure evidence. The SSA prefers seeking needed information directly from treating physicians. However, the SSA may order a consultative examination with an independent physician under the following circumstances:

  • The treating source cannot secure needed information for reasons such as lack of equipment.
  • The information in the case file contains contradictions that the treating source cannot address.
  • The treating source declines to provide the information or perform a new examination.
  • The SSA has reason to believe seeking the information from the treating source would not be fruitful.
  • The applicant requests evidence from another source based on legitimate reasons.

A consultative examination may provide information about a claimant’s medical history, diagnosis, prognosis and functional abilities. A consultative exam may also yield objective evidence, such as clinical and imaging tests.

Ensuring appropriate documentation

Treating medical sources are often best equipped to provide information about an applicant’s disabling condition. Treating sources are familiar with the symptoms, treatment history and progression of the condition. In contrast, independent physicians and other sources may lack the background to appropriately evaluate a condition.

To avoid evaluations from non-treating sources, applicants may want to speak with an Illinois disability lawyer before seeking benefits. A lawyer may be able to help applicants ensure that they provide adequate medical documentation from acceptable sources.