How a Medical Expert Can Help You Win Your Disability Case

Having a medical expert can increase the chances that you'll win your disability hearing.

By , Attorney (Seattle University School of Law)

Once your disability hearing has been scheduled, you'll receive a notice of hearing from the Social Security Administration (SSA). The notice will include the date, time, and location of your hearing. Your notice might also contain information about other expert witnesses who will testify during the hearing, such as a medical expert (ME).

Who Are the Medical Experts?

Medical experts are doctors hired by Social Security to provide independent testimony about your physical or mental conditions. Even though they're paid by the SSA, medical experts are required to be objective and provide an impartial opinion about your impairments.

Medical experts are often familiar with the SSA's rules and requirements for disability, and can help translate technical medical terms into a language that attorneys and administrative law judges can understand.

What Does a Medical Expert Do?

Medical experts review your medical records and answer questions from a judge about what the records contain. An ME can be present at your hearing to help the judge determine:

Ultimately, the judge will decide whether you're disabled, but testimony from a medical expert can be particularly persuasive, so having an ME say that your limitations are disabling is a significant plus for your case.

Not everybody who has a disability hearing will have an ME present (in fact, most hearings don't have an ME), but if you do have one, it's generally a good thing. Data published by the Government Accountability Office in 2017 showed that when medical experts testify at a disability hearing, the applicant ("claimant") is 160% more likely to be approved for benefits than applicants without testimony from a medical expert.

Why Is a Medical Expert Needed?

Social Security judges typically call medical experts when a claimant has a complicated medical issue or a rare condition that needs explaining. For example, if you have conflicting medical evidence or doctors can't reach a consensus on your condition, you're more likely to have an ME present during your disability hearing.

Medical experts are usually asked to help judges determine if a medical condition is severe enough to "meet or equal a listing." The Listing of Impairments—also called the Blue Book—is a category of disorders that the SSA considers automatically disabling (with the right medical evidence). Many of the evidence requirements are very technical, so judges can consult an ME when they need to make sense of the medical records and decide whether, according to a listing, a claimant is disabled.

When Do Medical Experts Testify?

Medical experts testify once you've scheduled a disability hearing and are at the hearing. Before you've reached the hearing stage of the disability determination process, the SSA does contact doctors, called medical consultants, who help claims examiners decide the outcome of your application. But you aren't able to cross-examine medical consultants the way you (or your representative) can question medical experts at your hearing.

Unlike vocational experts, who are sometimes physically present during disability hearings, most MEs will testify over the phone. Judges tend to ask for ME testimony early on in the hearing because, if the testimony is favorable, they're likely to have fewer questions and can wrap the hearing up quickly.

How Does Medical Expert Testimony Work?

A medical expert's resumé is submitted to Social Security before the hearing, so you or your attorney can have a look at the ME's professional qualifications ahead of time. Most medical experts that are requested specialize in the area of medicine that deals with your specific impairments. For example, somebody with a history of bipolar disorder might get a psychiatrist, while somebody undergoing cancer treatment should receive an oncologist.

During the hearing, the judge will swear the ME in, ask them to repeat their qualifications on the record, ask if they have reviewed all the available evidence, and then start with substantive questions about your medical conditions. Here's an example of typical ME testimony:

Not all medical expert testimony goes quite as smoothly as the above example, unfortunately. If your ME doesn't think you have that many limitations or disagrees with your disability onset date, you'll want a lawyer with you who can ask the right questions during ME cross-examination.

Can I Request a Medical Expert for My Hearing?

You can submit a written request for a medical expert to appear at your hearing to the office handling your claim, but ME requests aren't usually granted. Medical experts are a limited resource, so the SSA almost exclusively uses them in instances where they can't otherwise make a disability determination.

Because it's unlikely that you'll have an ME at your hearing, you should be prepared to have strong medical evidence supporting your disability claim. Judges don't usually need to consult an ME if you're ready with diagnostic test results (such as blood work, X-rays, or MRIs), treatment notes, and statements from your doctors.

For more information, see our article on the medical evidence required by Social Security.

Updated October 10, 2023

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