Doctor’s Letters

It is rather common for a client to come in with a letter from their health care provider. Frequently these people have filed their own applications for Social Security benefits and submitted this letter with their application. They are bewildered and crestfallen when they are turned down by the Social Security Administration. If they haven’t done their own application, we must be the one to tell them that the SSA won’t give much weight to the letter they have.

The first point I want to make is to thank the healthcare providers who have cared enough to write these letters. We know just enough about healthcare management to understand the pressure you have on your time. But your letter needs to do more than just say you don’t think your patient can work with their health problems.

Just recently we had a client come in with severe diabetic neuropathy. The client’s doctor had written a to-whom-it-may concern letter that stated, “his diabetic neuropathy is so severe he cannot work.” As sincere as the doctor was in writing this, the Social Security Administration will give it no consideration whatsoever.

If you want to help your patients in this situation, take a few moments to describe the limitations the patient has. It doesn’t have to be anything fancy, but if you can write a short paragraph describing limitations the patient has arising from his or her condition, it would be very valuable indeed.

The factors that the Social Security Administration considers in neuropathy cases affecting hands are: reaching, handling, fingering, feeling, pushing and pulling with upper extremities. With feet, the issues would be standing, walking, and pushing/pulling with the lower extremities. If the healthcare doctor had just set forth some simple, common-sense limitations this letter would have been very effective.

Here is an example:                

To Whom it May Concern:

I have treated Ms. Smith for her diabetic neuropathy for five years. In my opinion she is unable to work. She cannot use her hands to finger, feel, or manipulate objects. She cannot push or pull with her arms and hands without pain. Because of the neuropathy in her feet, she couldn’t stand or walk more than a few minutes at a time, certainly less than two hours a day. Because her problems wax and wane, she would have days when she could not even perform at this level.                                                                                                 Signed

                                MD/DO/APN/PA

This simple letter would take very little time to prepare. You don’t need a Residual Functional Capacity assessment. Just use the same skills you use in diagnosis. You certainly understand the real-world impacts of your patients’ illnesses and injuries.

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