LETTERS TO SUBMIT TO SOCIAL SECURITY
Letters from doctors, counselors, employers, friends and
families can help document
a person’s disability.
Following are sample letters from a doctor and a vocational
counselor.
Doctor’s
Letterhead
Date
Disability Determination Services
Street
City, State Zip
RE: Mary Jane
Smith SSN# 123-45-6789
Dear Sir or Madam,
I am a
family physician who has been caring for Mary Jane Smith since _______. She has multiple disabling complaints: headaches, fatigue, anxiety,
gastrointestinal malaise, heart palpitations, light-headedness, difficulty
breathing and menstrual irregularities.
After many office visits and tests we have come to the conclusion that
her condition is probably caused by multiple chemical sensitivity. This is a recently recognized medical
condition that causes a variety of symptoms affecting virtually every organ
system. In some patients these symptoms
may be transitory and mild and only of nuisance concern, but in Ms. Smith they
are severe and totally disabling.
. I do
believe Ms. Smith is totally disabled from work. There are no work environments in which she would be able to
function without suffering severe symptoms due to air conditioning, heating
units, office smoke, chemicals in carpeting and upholstery, and virtually any
environmental toxins.
I hope this
letter has been helpful. Please call or
write if you would like me to send over all office notes regarding Ms. Smith.
Sincerely,
John Jones, M.D.
State
of _______ Rehabilitation Services
Letterhead
Date
TO WHOM IT MAY CONCERN:
This letter is regarding Betty Brown, Social Security Number
123-45-6789, who met with me on __________ to discuss possible vocational
rehabilitation services. She is
applying for Social Security Disability Insurance.
Ms. Brown is a 51 year-old woman diagnosed with Multiple
Chemical Sensitivity (MCS), which has been described as an environmental
illness and a chemically induced immune system disorder. This means that she has serious health
problems after short-term exposure to nearly all indoor and outdoor
environments, such as fragrances, pesticides, building products, carpeting,
paper, inks, office machinery, soaps and detergents, fabrics, etc. The list is nearly endless.
Her physical reactions have been described as: fatigue, lack of energy, dizziness,
breathing problems, muscle and joint pain, sleep problems and depression. She indicated that she frequently feels
hopeless and has expressed a readiness to die.
Betty Brown has a Bachelor’s degree in Business
Administration, with an emphasis in Accounting from California State
University, obtained in 1978. She had
been employed from 1978 to 1998 as an accountant, bookkeeper/office manager and
tax preparer. Her last accounting job
was at XYZ Corp. She reported having to
leave this job due to an inability to function in the physical environment of
the office.
Ms. Brown is currently working seven to ten hours/week as a
housekeeper in chemically safe homes.
She has had to steadily cut back on work hours and numbers of homes due
to her MCS. She feels that she will
eventually not be able to work at all.
During our meeting, we discussed vocational options. It is my opinion that Betty Brown is not a
feasible candidate for vocational rehabilitation services, since she would not
be able to function in virtually any work environment. She indicated that she can tolerate only
limited exposure to computers; therefore, self-employment in the home would be
very difficult.
If I can be of further service in this matter, please let me
know.
Sincerely,
Michael Mitch, M. Ed., C.R.C.
Senior Rehabilitation Counselor
One MCS claimant was advised by an attorney to have friends, relatives and acquaintances send hand written or individually typed letters to the judicial law judge prior to a hearing. The letters should state how long they had known the claimant and discuss specific instances that they personally witnessed where claimant was adversely affected by chemicals. One such letter is included below.
Anxiety and depression are
aspects of illness so one example of a letter written from a mother's point of
view follows:
To Whom It May Concern:
Mary has tremendous anxiety
about her declining health and inability to
care for herself and her
family, and about the best options to prolong her remaining abilities and
functions. Meeting new people is anxiety-provoking.
Asking instructions or
directions at the main desk at a hospital or doctor office causes her a lot of
anxiety. She becomes confused, anxious,
and feels like she is not communicating properly about what she needs. She
worries that people do not properly understand her because of her anxiety.
Doctors have a very difficult time treating Julie as she cannot always express
herself. She has to work very closely
with her doctors to avoid this problem or have her husband come with her to
communicate with the doctor.
Her anxiety combined with
her pain and other impairments makes it
extremely difficult to
focus.
Mary becomes irritable and
very frustrated when she can't do the things she used to do. She becomes very
upset when she's at the doctor's office or other medical setting. I think it
becomes very difficult for doctors to talk to her, discuss her condition, their
findings, or their recommendations because she starts crying and becomes very
upset. She tries to not feel like this or be like this at these times but it
seems to happen anyway.
Please contact me if I can
help further with my daughter’s disability claim.
Sincerely,