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Home :: FAQ :: Physicians Issues

Is “Disability” a medical determination?

Yes and No. 

Yes.  A claimant may be entitled to SSDI or SSI if he or she meets a Medical Listing.  The Medical listing are specific listings of impairments and are set forth in the Social Security’s Guide named Disability Evaluation Under Social Security.  This guide is comprised of over two hundred and fifty pages of listed conditions and the criteria for meeting a listed medical condition.  The conditions include Musculoskeletal System, Special Senses and Speech, Respiratory System, Cardiovascular and Digestive Systems, Genito-Urinary System, Hemic and Lymphatic Systems, Skin, Endocrine System, Multiple Body Systems, Neurological Disorders, Mental Disorders, Neoplastic Diseases, Malignancies and Disorders of the Immune System.  These Systems shall be discussed further infra as to specific information and opinions sought to effectively determine whether a claimant will qualify for disability under any of the rubrics aforesaid.

No. “Disability” is an Administrative determination, not a medical one.  Life would be just too easy if a physician were to write a note that a claimant was “disabled” and he or she could get deserved benefits.  It would not be right either because some people can afford doctors who may want to help by writing such things and some people, especially the rural poor cannot.

By way of analogy, such a system would be like having a forensic pathologist come onto the stand in a homicide case and testifying before the jury that the defendant’s DNA was found at the scene of the crime and that the defendant was guilty and then the doctor would pronounce sentence, lead the poor defendant out of the courtroom and then pull the switch, much to the astonishment of the judge and the jury.

In both cases there are laws, due process and notions of equality and fairness involved. That is why doctors are asked to give opinions on medical issues and the sorts of limitations that the claimant has or can be expected reasonably to have based on his or her diagnostic test results and clinical findings.  Judges depend heavily on such things in coming to a sound and well reasoned conclusion as to why one claimant may be disabled and why another may not be.  A physician’s writing that a claimant is “disabled” is ignored and may actually cause an ALJ some ira, as the determination is the judge’s to make by law.  The statement that the claimant “is prohibited by his/her medical condition from engaging in either full time or interrupted part time employment” and a statement of the reasons therefore will hold great weight if such a statement comes from a treating physician.  We highly recommend the use of this language and supportive content, rather than simply saying or writing that a claimant is “disabled”.

Finally, since a determination of disability requires vocational and earnings calculations and analysis, physicians, unless they have a graduate degree in Vocational Evaluation, cannot give an expert opinion in these regards.  For example, if I am an attorney and blind in one eye and have no leg and am missing four fingers and have a bad back requiring me to be wheelchair bound, one might say I was disabled, however; if I am able to earn pay in excess of SGA levels I am not disabled even though I can only work, lets say ten hours per month.  That is why “Disability” is wisely left to the province of a judge, else wise, there would be too many attorneys collecting SSDI benefits. J)