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01

My doctor says I am disabled, but SSA keeps denying me?!?

Whether you can or cannot work is an issue reserved to the Commissioner.  

 

“A statement on an issue reserved to the Commissioner is a statement made by a medical source or a nonmedical source who is not part of the adjudicative team that would direct our determination or decision that the claimant is or is not disabled or blind within the meaning of the Social Security Act. We are responsible for making the determination or decision about whether a claimant is disabled or blind.”   

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Your doctor is not part of the adjudicative team at SSA and, therefore, cannot make a determination as to the ability of a person to work.

02

What statements are considered to be  Statements On Issues Reserved To The Commissioner?

These examples do not include every possibility, consider the following statements to be on issues reserved to the Commissioner. A statement indicating whether:

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  • the claimant is disabled, blind, able to work, or able to perform regular or continuing work,

  • the claimant has a severe impairment,

  • the claimant’s impairment(s) meets the duration requirement,

  • the claimant’s impairment(s) meets or medically equals any listing in the Listing of Impairments (Listings),  

  • the claimant has a specific residual functional capacity (RFC) using our programmatic terms about the functional exertional levels in DI 24510.006 Assessing Residual Functional Capacity (RFC) in Initial Claims (SSR 96-8p),

  • the claimant’s RFC prevents him or her from doing past relevant work,

  • the claimant meets the requirements of a medical-vocational rule in DI 25025.035 Tables No. 1, 2, 3 and Rule 204.00,

  • the claimant’s disability continues or ends when we conduct a continuing disability review (CDR),

  • a claimant’s drug or alcohol addiction is material to his or her disability,

  • a claimant failed to follow prescribed treatment, or

  • in a Title XVI child’s case, an impairment functionally equals the listings.

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03

So Now What?  Is there even a reason for me to go to the doctor?
Person with Crutches
Reviewing Legal Agreement

Your doctor is really important because they help take care of your health and provide information about your condition.

 

However, when it comes to the official decision about whether your health problem means you can't work, your doctor's opinion is just one piece of the puzzle. The SSA, not your doctor, makes the final decision regarding disability.

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Even though your doctor can't make the final call on these things, what they say about your health is still very important. It helps the SSA understand your situation better.

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