I was recently asked if you need a functional capacity evaluation (FCE) in a Social Security disability case. No, but it really helps if you can get one.

As I previously wrote, it is vital to get a statement from your doctor about your abilities and limitations in the workplace. This is sometimes called a medical source statement, medical opinion, or a statement of your residual functional capacity.

Normally, this medical opinion is just your doctor’s “best guess” of what you can and cannot do.  I don’t want to put this down. A doctor who knows your condition, and who knows you, can make a very good guess about how the conditions affects you and how it would affect you in the workplace.

However, a functional capacity evaluation objectively tests what you can and cannot do. A typical FCE will take 4 to 6 hours to test what you can do. You will be tired and quite possibly sore after it is done. However, this is often the very best evidence of your abilities and limitations.

Social Security already sent me to a doctor who had me bend and stretch. Is that the same thing?

No. You may have been sent for a consultative examination. However, that is a much shorter test. The consultative examiner may watch you walk and have you bend this way and that. From this minimal information, the consultative examiner extrapolates (makes a best guess) of your abilities and limitations.

If that leaves you furrowing your brow wondering how that tells what you can and can’t do? You’re right, it doesn’t (at least not very well). Unfortunately, Social Security will not send you for a functional capacity evaluation. If you want one, you will have to obtain it on your own (or with the help of your lawyer).

Why aren’t FCE’s performed in every Social Security disability case?

The problem is cost. A functional capacity evaluation will cost anywhere between $350 and $900 (depending on the therapist performing the evaluation and your location). In Pueblo Colorado, I see FCE’s running about $500. In Denver, the cost is closer to $850.

If you can have an FCE performed, that is great. I encourage you to do it. However, if you cannot afford an FCE, don’t give up hope! The majority of my clients cannot afford an FCE. I still find ways of building their cases.

Update 08/17/11: Another issue is that a FCE is often not performed by a doctor. That means the FCE report is often signed of by a therapist, who in Social Security’s eyes is not an “acceptable medical source.” However, Social Security Ruling  SSR 06-03p will allow Social Security to consider a therapists report as “other medical evidence.”

However, evidence from “other medical sources” is still not as good (all things being equal) as evidence from “acceptable medical sources.” ”Acceptable medical sources medical sources” are higher on the evidentiary totem pole than “other medical sources.” So, what can you do if you have a FCE completed by a therapist? Ask you doctor (likely to be an “acceptable medical source”) to review the FCE report and write a statement adopting the findings (with any changes if necessary) of the FCE.

eNewsMediaMagazine has some tips on building a strong Social Security disabilty claim:

Tip #1: Choose the right doctor(s).

Regardless of your specific disability, you will need medical documentation. The only way to do this is to visit at least one physician. Ideally, that would be an experienced, respected doctor in the field of your disability. The more specific the doctor to your disability, the more credibility he or she will have. For instance, if you claim to have back problems, but only see an MD for treatment, your records will probably not contain much useful information other than pain medication.

There is nothing wrong with this tip. However, for many people choosing which doctor they see, just is not an option.

If you are treating through a community health center, you are lucky to see a doctor for more than a few minutes, let alone choosing which doctor you see.

Many clinics which serve the poor, low income, and indigent “don’t want to get involved with the disability system.” This means that the only doctor you can see, may not want to fill out a residual functional capacity form for you.

Well, isn’t that just great!  The only doctor you can afford to see does not want to help you get your Social Security and Medicare/Medicaid which might actually help you get the care you need!  If you are in this position, sometimes you just have to shake the tree a bit to get some results.

Look the doctor in the eye and ask if he thinks you can work?

If the doctor answers, “no,” tell the doctor that without his or her help, you will probably be denied (which is true if you are unable to document the limitations caused by your disabilities).

Sometimes, a bit of brutal honesty helps shake a bit of humanity out of the bureaucracy many clinics are mired in. 

Read the rest of the article here. March 2, 2009 update: Sorry, the linked article is no longer available.

Have you had good or bad experiences dealing with your doctors?  Share your experiences in the comments.

You already know how important it is to get a Medical Source Statement in your Social Security disability case.

The best source for this is your own doctor.

However, I typically see Social Security have one of their technicians or a Social Security doctor, who has never seen or examined you, determine your limitations.

When I discuss this with my clients, I am often asked why? Why does it seem like Social Security purposefully avoids getting this information from the best source, your own doctor?

My opinion is that Social Security wants to ensure an objective opinion and believes that your own doctor won’t be objective. Social Security may be worried that because your doctor has been treating you for some time, he or she may write what you want rather than what the doctor really thinks.

I feel this is just bologna!

If Social Security won’t do it, you and your lawyer have to get this evidence from your doctor:

• This means getting your doctor to fill out a form;
• Or, write a letter.
• Sometimes, a doctor feels so strongly about a case, he or she will come in to testify.

It may seem like a small thing, but just getting your doctor’s perspective on your condition can make all the difference in your case.

To be found disabled, generally you have to show that you are unable to perform some type of full-time work. This is a simplification of the Social Security disability standard, but it is sufficient for this article.

The most common problem in Social Security disability claims is a lack of a statement of limitations from a doctor.

These statements go by different names:

• Medical Source Statement (this is the term Social Security uses).
• Medical Opinion.
• Statement of Limitations.
• Statement of Permanent Restrictions.

Whatever it is called, it tells Social Security what you can and cannot do. Social Security uses this to decide whether you are disabled.

Isn’t there a statement of limitations already in my medical records?

Probably not.

Most medical records contain a description of your symptoms, the objective findings, the doctors assessment, and the treatment plan. Most medical records do not have any statement of your limitations.

Doesn’t Social Security get a statement of my limitations?

They do. But, chances are it will not help you.

If you are reading this, you probably have already been denied. This means Social Security has already reviewed your medical records and formulated a statement of limitations. Since they denied you, Social Security’s statement of limitations is probably not good enough to prove you are disabled.

Even if you appeal, unless you have your own medically supported statement of limitations, you will probably be denied again. Social Security has a statement of limitations saying you can still work and you have nothing to disprove it. Even if their statement is wrong, if you do not have your own statement of limitations, you are at a disadvantage.

Even if Social Security has not yet made a decision on your case, do you really want a Social Security technician who does not know you, or a Social Security doctor who has never examined you, deciding what your limitations are?   Do you want that to be the only statement of limitations Social Security has when they decide your case? Of course not.

The best people to provide evidence about your limitations are your treating physicians. Your doctors know you and how your impairments affect you. If you are working with a lawyer, he or she can help you elicit a true and complete picture of your limitations from your doctors.

Whether you are fighting to get Social Security disability benefits on your own, or with a lawyer, keep in mind that a statement of limitations is a critical part of building your case, and the one element missing in most Social Security claims.