Obtaining Meaningful Medical Source Statements

As 11th century philosopher Solomon Ibn Gabirol once wrote, “a wise man’s questions contain half the answer.” An adjunct law professor at Temple would use this quote on multiple occasions to illustrate for my class the importance of crafting thoughtful questions for witnesses that would elicit helpful testimony without dredging up irrelevant or, worse yet, damaging testimony. As anyone representing Social Security Disability claimants knows, the rules of evidence in administrative hearings are far less formal than in traditional law. Specifically, hearsay is admissable, meaning that much of the questioning done by a representative occurs in the form of written questionnaires obtained from a claimant’s treating doctors. These questionnaires (known as medical source statements) form the centerpiece of most successful disability claims.???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????

Unfortunately, the standard approach to obtaining medical source statements in the field of disability does not involve much particularized anticipation of the doctor’s responses. Most send out the same generic forms for every client, varying them only generally when it comes to the doctor’s field of specialization. These generic forms tend to be exceedingly lengthy in an attempt to cover every possible topic that could arise in any claimant’s case. But in this case, less is more. Representatives could accomplish a lot more by at least redacting any questions on these forms that are irrelevant for each particular case. After all, including many irrelevant questions on a doctor’s questionnaire can jeopardize a claim in several ways, including:
  1. It’s less likely that doctors (who sometimes tend to be just a little bit busy) will even attempt to respond to a questionnaire that is several pages long. I should note that a doctor has absolutely no obligation to complete these forms.
  2. It’s more likely that a doctor would get frustrated with a form that asks multiple complicated, clearly irrelevant questions and stop completing it altogether. I gather this because I’ve reviewed forms where doctors gave expectantly pithy or terse responses to irrelevant questions early in the form then barely answered later questions (which were actually relevant).
  3. Sometimes asking a dumb question invites a dumb answer. As an example, often these forms will include a question about whether a claimant has any limitations with fine/gross handling, even if claimants aren’t including this allegation on their disability claim. If a doctor answers affirmatively for whatever reason (whether in haste, in regards to a temporary ailment but not a disability, etc.) it can discredit their entire opinion, particularly as these forms rarely ask for explanations.
In the end, maybe a more modern phrase describes this problem better than a quote from an 11th century philosopher: “Garbage in, garbage out”. If a representative
 fails to take the questionnaires they send out to doctors seriously (eg. by actually personalizing them according to the particular case they’re investigating), they can only expect to get at best imperfect responses.

 

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