How do I fill out the forms from the SSA

Social Security forms frequently cross a physician's desk. They are often multipaged documents asking many questions. They can be daunting for those who do not understand the process of how the SSA determines disability. The completed forms are intended to provide background information to the impairment and disability evaluator in the Social Security system. An independent impairment examination also may be performed on such patients. The attending physician's report is used to provide background information so that a decision can be made whether or not a person qualifies for Social Security disability. If the information provided does not allow the decision makers to answer the questions regarding qualifications, then a separate examination, paid for and scheduled by the SSA, will be performed. It is not the attending physician's job to perform an impairment evaluation, obtain consultation with other physicians, or perform additional diagnostic testing. On occasions, the SSA will ask the attending physician to provide on opinion regarding his or her patient's ability to perform remunerative employment, but these opinions are not to be provided unless asked for.

18. During work hours, a man slips on ice while delivering packages for his job. He has the sudden onset of pain and discomfort in his lower back. He has pain and numbness and tingling in his right leg. After treatment with analgesics and physical therapy, he recovers. Two years later, he has a similar injury. A magnetic resonance imaging (MRI) discloses a herniated disc at the L4-L5 interspace. He has surgery because of persistent, severe symptoms. He has a successful outcome and returns to the work force. He is asymptomatic except for mild discomfort in the lower back after a long day. Does the man have an impairment? If so, how much?

Certainly the man has an impairment based on the anatomic deviation from normalcy. Using the AMA Guides, he has 10% impairment of the whole person because of the herniated disc and neurologic abnormalities, despite the fact that he has had a successful operation and is now relatively asymptomatic.

19. The same man returns to work and slips and falls again. His symptoms are now severe. He has constant low back pain. He can no longer participate in sports activities, which he enjoyed in the past. He cannot go back to work in his heavy manual labor job. These symptoms have persisted for the past 4 years, and he has been told that he is not a surgical candidate. Does he have an impairment? If so, how much?

This man continues to have impairment caused by the first and second injuries and has been made worse (exacerbated) by the third. However, no further impairment is awarded. The 10% impairment that he received originally (although he was essentially asymptomatic at that time) was given because of the known risk for further problems as time passes. Thus, there is no increase in the impairment rating.

Key Points

1. Impairment reflects an alteration from normal bodily functions, can be assessed using traditional medical means, and can be objectively determined.

2. Disability results from impairment, is task-specific, and is measured in the context of the system to which the worker has applied for relief. Disability determination is an administrative determination that uses both medical and nonmedical information.

3. One individual can be impaired significantly and have no disability, while another person can be severely disabled with only a limited impairment.

Websites

1. Help for health professionals to understand the Social Security Disability determination process: http://www.ssa.gov/disability/ professionals/index.htm

2. Impairment rating and disability determination: http://emedicine.medscape.com/article/314195-overview

3. Information and technical assistance relating to The Americans with Disabilities Act: http://www.ada.gov/

4. Musculoskeletal disorders and workplace factors: http://www.cdc.gov/niosh/docs/97-141/

5. Social Security Administration, U.S. Department of Health and Human Services: Disability Evaluation under Social Security. Available only online: http://www.ssa.gov/disability/professionals/bluebook

BiBLiOGRAPHY

1. American Medical Association. Guides to the Evaluation of Permanent Impairment. 5th ed. Chicago: American Medical Association; 2000. p. 2-5.

2. American Medical Association. Guides to the Evaluation of Permanent Impairment. 6th ed. Chicago: American Medical Association; 2008. p. 572.

3. Barth PS. Economic costs of disability. In: Demeter SL, Anderson GBJ, Smith GM, editors. Disability Evaluation. St. Louis: Mosby; 1996. p. 13-9.

4. Barth PS. Economic costs of disability. In: Demeter SL, Andersson GBJ, editors. Disability Evaluation. 2nd ed. St. Louis: Mosby; 2003. p. 20-7.

5. Bell C, Judy B. Overview of the Americans with Disabilities Act and the Family and Medical Leave Act. In: Demeter SL, Andersson GBJ, editors. Disability Evaluation. 2nd ed. St. Louis: Mosby; 2003. p. 664-71.

6. Demeter SL. Appendix B. In: Demeter SL, Andersson GBJ, editors. Disability Evaluation. 2nd ed. St. Louis: Mosby; 2003. p. 871-91.

7. Demeter SL. Contrasting the standard, impairment, and disability examination. In: Demeter SL, Andersson GBJ, editors. Disability Evaluation. 2nd ed. St. Louis: Mosby; 2003. p. 101-10.

8. Elisburg D. Workers' compensation. In: Demeter SL, Andersson GBJ, Smith GM, editors. Disability Evaluation. St. Louis: Mosby; 1996. p. 36-44.

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