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Can Medical Experts Help with Social Security Disability Claims?

Can Medical Experts Help with Social Security Disability Claims?


Insufficient medical evidence is one of the most common reasons for denials of Social Security Disability claims. This fact might lead you to wonder if a medical expert would help you gain approval upon appeal. The answer is: You still need adequate evidence from a doctor, but testimony from a medical expert can sometimes help too.


First, let’s review the types of medical evidence needed by Social Security to determine your claim. Generally speaking, you need to provide:

  • Diagnostic test results
  • Doctor’s treatment notes
  • A statement from your doctor describing your functional limitations

It’s important to remember that most cases are decided on the basis of medical records as described above.


But sometimes medical evidence is lacking. This can happen when doctors are limited  in their ability to provide evidence for disability claims, often due to practice-wide policy or HMO rules. Or, in some cases, a claimant has not had access to medical care due to lacking health insurance for many years.


Occasionally, a claimant’s condition itself has made it difficult for them to seek medical care (such as a mental or emotional condition that made them distrustful of doctors or unable to admit they needed care).


In the above examples, and perhaps some other types of cases, medical evidence can be lacking. These claimants are often sent by Social Security to something called a “consultative exam”. These types of exams are often quite limited, and don’t provide enough evidence to help the claimant gain an approval for benefits.


When your appeal reaches the hearing stage, the judge might call in a medical expert. This is usually done when your condition is rare or complicated, and the judge needs additional explanations on how the condition meets impairment standards. The medical expert might also clarify how your condition prevents you from performing certain work-related activities. However, is is usually the judge who decides to call in a medical expert, not the claimant.


For more information on medical evidence and how it relates to your case, give us a call. A disability attorney can review your case, help you gather necessary evidence, and advise you on additional steps you can take to potentially win your case on appeal.