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What Is Needed For Legal Representation For Social Security Disability And Medicare Benefits — BASED PRIMARILY ON MENTAL IMPAIRMENTS

Diagnoses are not enough. For example, diagnoses of anxiety, PTSD, depression, bipolar, insomnia, are very common. People still work with these diagnoses. To qualify for disability, the law requires that medical providers also document severe symptoms that limit a persons’s ability to function, in the treatment notes. Treating providers must provide their best opinions on a person’s capacity to physically and mentally function in a work type environment, on a sustained basis.

Mental health diagnoses are often made based upon subjective reporting by the patient/client. There is no objective testing available to confirm mental health diagnoses, and there are no objective tests to measure the severity of the symptoms. Work requires the ability to physically function and to mentally function, that is, to adhere to a work schedule, deal with coworkers and supervisors, and focus attention long enough to complete work tasks. It also includes how well a person can maintain social
standards, and communicate appropriately with others, how well a person can concentrate, whether the person can tolerate stresses common to a work setting, whether the person can maintain attendance, whether the person can follow directions and can respond appropriately to criticism from supervisors, whether a person can work in coordination with others without being unduly distracted, and whether the person can perform at a consistent work pace.

Please ask your providers to provide you with treatment notes and written explanations addressing the issues above. Without this information, an application based primarily upon mental impairments will not likely be successful. I am more than happy to speak with treating providers if they have questions about what is needed for documentation.

5 Step Sequential Analysis

The determination of medical disability for Social Security Disability benefits requires the application of a 5 step legal analysis. Whether a person medically qualifies for disability benefits is a legal decision, not solely a medical decision. To qualify for such
benefits, the following 5 step analysis is applied.

Frequently, claimants for disability benefits fail at steps 4 or 5, even though they have serious medical impairments. The claimant has the burden of showing, through medical treatment records and opinions from treating providers, that the medical impairments result in severe functional limitations, such as the inability to stand or walk, or to concentrate their attention long enough to complete a mental work task. The functional limitations must prevent not only past work, but all other work in the national economy

Step 1 – Is Claimant engaged in substantial gainful activity?

Step 2 – Does Claimant have a medically determinable impairment, or a combination of impairments that is “severe”?

Step 3 – Does the Claimant’s impairment or combination of impairments, meet or medically equal the criteria of a listed impairment?

Step 4 – What is the Claimant’s Residual Functional Capacity (RFC)? Can the Claimant perform the requirements of past relevant work?

Step 5 – Is the Claimant able to do any other work, Considering RFC, age, education and past work experience?

Gawryl & MacAllister

For mailing purposes use:

PO Box 788
Nashua, NH 03061

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