Submitting Evidence to Social Security: Your Responsibility

The Social Security Administration has enacted new regulations that clarify what evidence you and your attorney must provide to Social Security. When you apply for Disability benefits, you are required to tell Social Security about all evidence that relates to your claim – even if it hurts your case. Your lawyer or representative has the same obligation to turn over or tell Social Security about evidence. You are required to provide Social Security the following:

  •  Medical Records
  •  Medical Opinions
  •  Medical Examinations

There are only two narrowly defined exceptions: 

  • Your Attorney’s Work Product: This only covers your “attorney's analysis, theories, mental impressions, and notes.” 
  • Information covered by the Attorney Client Privilege: The attorney-client privilege protects confidential communications between an attorney and their client that are related to providing or obtaining legal advice.

Neither of these exceptions includes factual information, medical source opinions, or other medical evidence. Indeed, concealing or hiding evidence from Social Security could result in criminal or civil penalties.

The Bottom Line:  Turn over all information to Social Security that relates to your claim – even if it hurts your case!   

The Inability to Walk Effectively

Photo by alblec/iStock / Getty Images

Photo by alblec/iStock / Getty Images

Arthritis and other musculoskeletal problems can cause severe pain and limit mobility.  If your arthritis limits your ability to walk effectively, you may be disabled under Social Security Rules.   Examples of being unable to walk or “ambulate” effectively may include any of the following:

-         You need two canes, two crutches or a walker to get around.

-         You are unable to walk a block at a reasonable pace on uneven surfaces.

-         You are unable to take standard public transportation.

-         You are unable to do your own shopping or banking.

-         You can’t climb a few steps at a reasonable pace with the use of a single hand rail. 

Social Security recognizes that in order to work at any job, even a sit down job, you need to be able to get to work as well as move around the office.  If you can't walk effectively, you might be disabled. 

Social Security Issues New Ruling on Evaluating Claimant's Symptoms: SSR 16-3p

The process of applying for Social Security Disability (SSDI) benefits can leave claimant’s feeling like they are on trial. Some Social Security Administrative Law Judges (ALJs) scrutinize applicants’ character and lifestyle when determining if they are disabled. Social Security has issued a new ruling making it clear that in evaluating a person’s symptoms, Social Security ALJ’s are not supposed to judge applicant’s character or overall truthfulness. The new rule reads:

Adjudicators must limit their evaluation to the individual’s statements about his or her symptoms and the evidence in the record that is relevant to the individual’s impairments. In evaluating an individual’s symptoms, our adjudicators will not assess an individual’s overall character or truthfulness in the manner typically used in an adversarial court litigation. The focus of the evaluation of an individual’s symptoms should not be to determine whether he or she is a truthful person.

In addition to telling ALJ’s “what not to do,” the ruling gives guidance to ALJs on how to evaluate a claimant’s statements about their symptoms. The ruling states:

In considering the intensity, persistence and limiting effects of an individual’s symptoms, we examine the entire case record, including the objective medical evidence; an individual’s statements about the intensity, persistence and limiting effects of symptoms; statements and other information provided by medical sources and other persons; and any other relevant evidence in the individual’s case record.

1.  Objective Evidence: 

When evaluating a claimant’s symptoms, the ALJ should look at the objective evidence. Objective evidence includes things like X-Rays, MRIs and range of motion tests. In some cases, the objective evidence may reasonably relate to the intensity of the symptoms. However, a Claimant’s testimony about their symptoms cannot be disregarded solely because it is not supported by the objective evidence.

2.  Other Evidence:

  • Claimant’s Statements: When evaluating a claimant’s symptoms, the ALJ should look to the claimant’s own statements both to his or her doctors and to Social Security about his or her symptoms.  
  •  Medical Sources:  When evaluating a claimant’s symptoms, the ALJ should look to the opinions and statements of Doctors and other medical treatment providers.
  •  Non-Medical Sources:  When evaluating a claimant’s symptoms, the ALJ should look to the personal observations of family and friends and other non-medical sources. The ALJ should consider these observations in determining how consistent these are with the claimant’s own report of their symptoms.  
  • Other Factors:  Other factors that should be considered in assessing the claimant’s symptoms are claimant’s daily activities, medication and treatment. 

The Bottom Line:   Judges should look at the Medical Record, not your character, to evaluate a claimant's symptoms.  

Mental Consultative Examinations (CE)s

Photo by alexsokolov/iStock / Getty Images

Photo by alexsokolov/iStock / Getty Images

Social Security may ask that a doctor evaluate your mental health or cognitive problems. These examinations are conducted by Psychiatrists or Psychologists.   The doctor will conduct a Mental Status Exam (MSE) which assesses your appearance, behavior, speech, mood, affect, thought process, thought content, cognition and insight or judgment.  The doctor may also administer other tests such a memory, personality or intelligence tests. 


1.      Go to the Evaluation:   If you refuse to go to the examination, Social Security will likely deny your claim.   Social Security only purchases evaluations in cases where they do not believe there is sufficient evidence to determine disability.  If you do not go to the evaluation, Social Security will make a determination about your case, based on the evidence currently in the file, and that determination will likely be a denial.   

2.      Try your best:  Put forth your best effort on all written and oral tests.  If you don’t try your best, the doctor may find that you are “malingering” or faking it.   This finding is very difficult to overcome in a Social Security Disability Case.

3.      Dress Normally:   Don’t dress up or try to look professional for the Consultative Examination.   The doctor will be judging you based partly on how you look.   Dress as you do on a typical day at home.   If you typically wear sweatpants, then you should wear sweatpants to your evaluation.    If you don’t bathe most days, then don’t bathe for the examination.  This is not the time to “dress to impress.”   You want to show the doctor your problems, not hide them.

4.      Tell (and Show) the Doctor your Problems:  While it may be embarrassing, it is important that you tell the doctor about your problems.   Many people want to hide the fact that their house messy, they rarely bathe, and they are unable to keep friends. It is also okay to cry during the examination.   If you are in pain, it is okay to ask to be able to change positions.  No matter what your problems are, don’t hide them.  

5.      Don’t take Extra Medication:   You may be tempted to take extra anxiety medication to get through the examination.   Don’t do it.  You want the doctor to see your problems.  Just take your normal medications.   

6.      Take Notes:   After the evaluation, take a few minutes to take notes about your experience.   How long was the evaluation?   What kinds of questions were you asked?  What did the doctor say to you?    What did you tell the doctor?  

No Social Security Cost of Living Increase in 2016

Social Security recipients, that include the disabled and the retired, will not see an increase to their benefits in 2016. The Social Security Administration has decided not to give recipients a cost of living adjustment (COLA) because according to the Consumer Price Index, prices have not risen. Social Security ties cost of living increases to the rate of inflation as determined by the Consumer Price Index. The theory is that if prices don’t go up, then benefits should not increase. Unfortunately, the Consumer Price Index does not accurately measure the way most disabled and retired people spend their money. The Consumer Price Index is heavily tied to the price of gasoline which has dropped significantly. Most disabled and elderly people don’t spend a large portion of their income on gasoline because they don’t drive back and forth to work. Other prices, which the Consumer Price Index does not weigh as heavily, are up. For example, housing costs have gone up 3.2 percent and food prices were 1.6 percent higher. Even worse, Medicare premiums will rise in 2016 for many elderly and disabled people. Most of these premiums are taken directly from Social Security benefits. As a result, many people will see their benefits go down.  




Social Security has issued a new ruling for evaluating Interstitial Cystitis, a disorder that causes recurring pain in the bladder or pelvic region.  SSR 15-1 p.  Unfortunately, Interstitial Cystitis it is very difficult to diagnosis.   The American Urological Association supports a diagnosis of Interstitial Cystitis when bladder pain and other symptoms last for more than six weeks “in the absence of infection or other identifiable causes.”  Because Interstitial Cystitis is so difficult to diagnose, Social Security’s new ruling identifies when the Agency will recognize Interstitial Cystitis as a “medically determinable impairment.”   It must be:

1)      Diagnosed by A Doctor:     In order for Social Security to recognize the impairment of Interstitial Cystitis a Medical Doctor (MD) or Osteopathic Doctor (OD) must make the diagnosis based on medical history and a physical examination. 


2) Be Supported by Medical Signs - Laboratory Tests OR Be Accompanied by a Diagnosed Mental Health Condition:  Medical Signs include bladder wall stiffening, bleeding or ulcers.  Laboratory Tests can include repeated urine tests which are negative for infection even though symptoms persist.   Social Security recognizes that people who have Interstitial Cystitis may have ongoing mental conditions such as anxiety or depression associated with their Interstitial Cystitis.   If you have a documented mental condition, your Interstitial Cystitis will be recognized by Social Security as a recognized medically determinable impairment.


Interstitial Cystitis may be disabling for many reasons.  These are just a few: 

  • Inability to Concentrate:   Chronic pain from Interstitial Cystitis may affect the ability to focus and sustain attention on the task at hand.  Waking up at night to urinate may also lead to fatigue and the inability to concentrate.
  • Frequent Breaks:  Urinary frequency can make it necessary to take trips to the bathroom every 10 to 15 minutes. 
  • Absences from Work:   Pelvic Pain from Interstitial Cystitis may be so severe that the individual may miss work more frequently than an employer will tolerate.   

THE TAKEAWAY:   Social Security's new ruling explains When the agency will find Interstitial Cystitis  to be a medically determinable impairment and recognizes that it can be disabling.  

FAQ: Should I Get a Lawyer Before I Apply For Disability or Wait Until I am Denied?

Most people benefit from getting a Social Security Lawyer before they apply for disability benefits.  There is a widespread belief that “everyone is denied at application,” this is not true.  In Washington State, about 40 percent of applicants for Social Security Disability Insurance (SSDI) benefits are awarded at the initial application level.   If you have a lawyer early on, they can work with your doctor to provide reports explaining the limitations you have as a result of your disability.  While Social Security will get the medical records from your doctors, they usually do not ask your doctor for opinions about your limitations.  Getting this evidence early in the case makes it more likely that you will get benefits at the initial application stage.     Increasingly, as the Seattle hearing office has gotten more conservative, it is harder to win at the hearing level.  By having a lawyer who will get the evidence of your disability at the beginning of the case, you have a better overall chance of getting benefits.   Even if you are not awarded benefits at the initial application stage, your lawyer can give you advice that may help you down the road.   For example, your lawyer can explain the importance of reporting your symptoms or problems accurately to your doctors.