Medical Source Statements

A medical source statement is an opinion from your doctor regarding the nature and severity of your limitations due to your medically-determinable impairments. A medical source statement is often simply a form that is completed and signed by your doctor setting forth the doctor’s opinion regarding your functional limitations.

The SSA must consider your treating doctor’s opinion. See 20 CFR 404.1527.

Here are the forms I use. The first form is used to describe physical limitations. The second form is used to describe mental limitations.

“Medical Source Statement of Ability to do Work-Related Activities (Physical)” form HA-1151. Download MSS Physical as PDF
“Medical Source Statement of Ability to do Work-Related Activities (Mental)” form HA-1152-U3. Download MSS Mental as PDF

Gordon GatesAttorney

Gordon Gates specializes in Social Security disability law, and he handles claims at every level of the Social Security disability claim process. He assists clients…

Gordon Gates specializes in Social Security disability law, and he handles claims at every level of the Social Security disability claim process. He assists clients with initial applications for disability benefits, with appeals of denied claims, and with hearings by an administrative law judge.

Gordon has successfully appealed unfavorable administrative law judge decisions the Social Security Appeals Council and to U.S. District Court (District of Maine) to have those claims remanded for new hearings.

Gordon attended Maine Maritime Academy and Tulane University Law School. At Tulane, he served as Senior Articles Editor of the Tulane Law Review and graduated magna cum laude. He was admitted to practice law in Maine in 1991. Since 2005, he has concentrated his law practice on Social Security disability and SSI cases.

Gordon is the publisher of Social Security Disability Lawyer, a nationally-read legal blog. He presented at the Fall 2010 conference of National Organization of Social Security Claimants’ Representatives (NOSSCR) on the topic of Writing Hearing Briefs for the ALJ.

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Medical Source Statements

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