Debunking Forms: The Medical Source Statement (Physical)

For the month of March at Jan Dils Attorneys at Law, we are going to be providing information that will help you complete Social Security Administration (SSA) forms completely and accurately.

Today, we’ll begin with the Medical Source Statement form for physical disabilities (Form HA-1151-U5). As the name indicates, this form will be completed if your disability is based on a physical problem, as opposed to a mental disability.

With this form, your physician will be asked to determine your ability to perform work-related activities with attention to specific functions. It’s important to describe your limitations in detail to your physician—especially the contrast between your abilities before and after the onset of your condition.

Note: If you are represented by an attorney, he or she will contact your physician to facilitate the completion of Form HA-1151-U5.

Specifically, your physician will be supplying information about your ability to lift/carry objects; any impairment in standing, walking or sitting; activities such as climbing, balancing, crouching, kneeling, and crawling; any environmental restrictions such as chemicals or humidity that may affect your disability; and answering other similar questions.

You can find the most up-to-date version of this form by visiting the forms page of the Social Security Administration’s website or by contacting your local Social Security office.

Attorney Jan Dils describes the application process in further detail in her book, Getting the Social Security Benefits You Deserve, which you can request for free here.

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Jan Dils, Attorneys at Law

Jan Dils, Attorneys at Law