What Do I Need From My Doctor to Qualify for Disability Benefits?

The Social Security Administration (SSA) relies on doctors' records and medical evidence to determine whether you're disabled. Although the SSA will request records from the list of doctors you have given them, it's your responsibility to ensure that the agency has received all of your relevant medical records and that your doctors have provided the information in a helpful way.

Submitting accurate and complete information from the doctors who treat you for your impairment is vital to winning your claim. You should make every effort to get the most updated records from your doctors' visits and submit them to the SSA at each stage of the disability determination process. Knowing what to ask for can help increase your chances of getting benefits and cut down on the time you'll be waiting for a decision.

Which Doctors' Records Do I Need for My Disability Claim?

You need to get medical records from any doctors who have treated you for your disabling condition. If you have multiple disabilities, you'll need to provide the SSA with medical records from all of the different doctors who have treated you.

Don't swamp the SSA with medical records that aren't relevant to your disability claim. For example, if your claim is based solely on depression, you don't need to provide records from your allergist, eye doctor, or any other physicians who are unfamiliar with your mental condition.

What Information Do I Need to Get From My Doctor?

The specific information you need to get from your doctors will depend on the type of medical condition that forms the basis of your disability claim. Here are some examples.

Physical impairments. Say you're filing for disability due to lumbar and thoracic spinal stenosis. You've received treatment from an orthopedic doctor, a neurosurgeon, a physical therapist, and a pain management doctor. The SSA will want to see the following documents:

• copies of CT scans, X-rays, and MRIs that show the extent of the spinal stenosis
• radiologists' reports that describe the findings from imaging studies
• records from any surgical treatments or injections to relieve the symptoms (for example, decompression surgery or steroid shots)
• notes from your pain management visits, including medication list, dosages, and reported side effects
• a detailed physical therapy plan and how you responded to treatment
• statements from your doctors about your ability to work, and
• physical residual functional capacity (RFC) assessments.

Doctors' statements and RFC assessments are particularly valuable for your disability claim. (More on what these statements should contain below.)

Mental illness. Say you're filing for disability based on bipolar disorder and generalized anxiety disorder. You've attended an in-treatment program at a local psychiatric facility as well as individual outpatient counseling and talk therapy. The SSA will need the following information:

• a list of your medications, including dosage amounts, reported side effects, and a doctor's statement regarding compliance
• a psychiatric evaluation where you're formally diagnosed with bipolar and generalized anxiety disorder using the Diagnostic and Statistical Manual of Mental Disorders
• a mental RFC prepared by your psychiatrist, psychologist, or (ideally) both
• statements from your doctors that drugs and alcohol don't contribute to your symptoms
• notes from mental health facility providers containing their observations on your ability to interact with other patients, and
• your psychiatrist's opinion on whether you meet or equal a disability listing.

Disability listings are health conditions that the SSA considers severe enough to be automatically disabling. Having a medical provider's opinion that you meet or equal a "listed impairment" is often persuasive evidence that you're disabled.

Combined physical and mental impairments. Lastly, say you're filing for disability based on diabetes, chronic obstructive pulmonary disease (COPD), and depression. Unsurprisingly, you'll need to provide both physical and mental medical information to support your claim:

• physical RFCs from heart and lung doctors
• lab results or exercise stress tests showing greatly reduced lung function
• formal mental evaluations and RFCs from a psychiatrist or psychologist
• doctors' statements saying drugs and alcohol don't contribute to your depression
• statements regarding the likelihood that your medical conditions will improve, and
• a list of medications you're taking and any documented side effects.

Not every disability claimant will have all of the necessary documents mentioned above, and you can still win your disability claim if you're missing a doctor's opinion, for example. However, submitting progress notes from your physicians and mental health providers is pretty much non-negotiable— it's extremely difficult to get disability if you don't have evidence of doctor's visits.

How Your Doctor Can Help Prove You Meet a Disability Listing

The SSA outlines over 100 medical conditions ("listings") that—if you have evidence showing that you meet certain criteria for the listing—make you eligible for automatic approval of your claim. If your doctor thinks that your condition qualifies for automatic approval under a listing, they should complete a form explaining why they think you meet the listing with reference to relevant medical documentation.

For example, if you've been diagnosed with a type of skin cancer known as sarcoma, you can be eligible for automatic benefits approval under the disability listing for skin cancer, but only if the cancer has spread (metastasized) to or beyond the regional lymph nodes. You can establish that you meet the listing criteria by providing the SSA with a pathology report containing your initial sarcoma diagnosis, biopsies showing that the cancer has spread, and any surgical records following excision of the tumor cells.

How Your Doctor Can Help Determine Your Residual Functional Capacity (RFC)

Your RFC (which stands for "residual functional capacity") is a detailed assessment of your ability to perform certain work-related activities in light of your symptoms. Your RFC represents the most intensive work you can do on a regular and sustained basis. RFCs can contain both physical and mental restrictions.

When you submit your disability application, a claims examiner and a medical consultant who works for Social Security will create an RFC for you using the medical evidence in your file. But it helps if your doctor also submits an RFC form. If your condition doesn't meet a listing, then RFCs are one of the most important things that your doctors can provide to help your claim.

Keep in mind that in order to be helpful, your doctors' RFCs must be supported by objective medical evidence. If the opinions don't line up with the evidence—for example, your doctor says you can't lift anything heavier than 10 pounds but you don't have any X-rays or MRIs showing a torn rotator cuff, nerve impingement in the cervical spine, or any other abnormality that would suggest such a significant limitation—Social Security can disregard the doctor's opinion.

What Your Doctor Should Put in a Physical RFC

Here are some examples of the things that a physical RFC should discuss:

• how much weight you can lift (in pounds) and how often
• how much weight you can carry and how often
• how long (in hours or minutes) you can remain seated at one time
• how long you can stand (uninterrupted)
• how far (in distance or time) you can walk
• any environmental restrictions you have, such as sensitivity to dust or temperature
• any postural restrictions, like an inability to stoop, bend, or kneel
• any manipulative limitations (difficulty using your hands, fingers, or arms) and
• sensory limitations, such as vision or hearing difficulties.

You can download a physical RFC form to give to your doctors to complete. If you have an attorney or disability advocate helping you with your claim, they should provide one to your doctors.

What Your Doctor Should Put in a Mental RFC

Here are some things that a mental RFC should discuss:

• how well you can understand, remember, and carry out simple instructions
• whether you can interact appropriately with co-workers, supervisors, and the general public
• your ability to react to criticism or authority figures
• any difficulty you have with memory and recall
• your ability to maintain appropriate workplace attire and hygiene
• how long (in minutes or hours) you can concentrate and focus long enough to complete basic tasks
• any workplace disruptions your condition may cause, and
• whether you're able to maintain regular work attendance.

Being unable to maintain regular attendance is a limitation that Social Security considers "inconsistent with competitive employment," so if your doctor thinks that you'd be unable to attend work regularly due to issues like fatigue, pain, side effects from medication, or frequent hospitalizations, they should include the exact number of days you'd miss (per week or month) in the RFC assessment.

Even if you're completely clean and sober, your mental RFC should discuss your relationship to drugs and alcohol. Your doctor should note whether you currently use drugs or drink alcohol, and, if so, whether your mental health condition would still exist if you stopped using. The reason your doctor should address these issues is because if substance abuse is "material" to your claim—meaning the condition would go away if drugs or alcohol weren't in the picture— Social Security will most likely deny your claim.

Talking to Your Psychiatrist About Your Mental RFC

Before your psychiatrist, psychologist, or other mental health professional completes the RFC form, you should have talked with them about what you can and can't do on a day-to-day basis. Sharing your honest opinion about your ability to interact with co-workers, maintain focus, and perform other work-related tasks will give your psychiatrist insight into the troubles you would face in the workplace. Of course, your psychiatrist will have their own opinions on what you're able to do, but many doctors find it helpful to hear their patients' self-described limitations.

Above all, be sure to obtain as much mental health treatment as you reasonably can, both for your own health and for the sake of your disability claim. The more you can explain to your psychiatrist the symptoms you're experiencing—whether panic attacks, suicidal thoughts, mania, hallucinations, or something else—the greater your chances of success in your disability case. For more information on how your psychiatrist can help determine your RFC, see our article on mental RFCs.

Frequently Asked Questions (FAQs)

Below you can find answers to some frequently asked questions about your doctor's role in your disability claim.

Can My Doctor Refuse to Help Me With My Claim?

Your doctor cannot withhold medical records from Social Security as long as you've signed a release form (SSA-827, Authorization to Disclose Information to the Social Security Administration) that allows the agency to obtain the records. However, your doctor isn't obligated to fill out an RFC form or write a medical source statement on your behalf. If your medical provider seems reluctant to provide their opinion, check out our article on how to get your doctor's help to approve your disability claim.

When Should I Apply for Disability?

You should apply for Social Security disability as soon as you expect to be unable to work full-time (meaning at the level of substantial gainful activity) for at least twelve months. The SSA doesn't award temporary or short-term benefits, so if you think you'll be able to return to work within a year, you should wait to see whether your disabling condition improves significantly.

What If My Application Was Already Denied?

About 65% of disability applications are denied at the initial level, but that doesn't mean that you aren't disabled. You can appeal the denial and eventually request a hearing with a disability judge, where you have the greatest chances of winning your claim. Remember to provide the SSA with updated medical records each time you submit your appeal.

Can a Disability Lawyer Help With Getting Medical Records?

Because the medical evidence and doctors' opinions you provide to the SSA in support of your claim will largely determine whether you win or lose your disability claim, you may want to hire a lawyer. Experienced disability attorneys and advocates are trained to identify what type of information you need to win and will look over your case to determine what further evidence you need. If you're worried about cost (as many disability applicants are), keep in mind that disability lawyers aren't paid unless you're approved, so there's little risk in hiring one to help.