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Sample Psychologist-to-SSA Letter

Sample Psychologist-to-SSA Letter This Sample Letter is designed as a guide to help you draft a personalized medical report documenting mental impairment. [Psychologist s Name] [Street Address] [City, ST ZIP] [DATE] [Recipient Name] [Title] [Company Name] [Street Address] [City, ST ZIP] Re: [Patient Name; Date of Birth; SSN] To Whom It May Concern: My patient [NAME] has [MS diagnosis and relevant condition] that is severe. The neurological problems caused by the MS have been documented elsewhere by [his/her] physician. [HE or SHE] is limited in daily activities and is unable to work on a sustained basis. I have interviewed [NAME] and administered a battery of standardized neuropsychological tests, including [FULL LIST OF TESTS, DATA, AND RESULTS]. [NAME] has at least two specified impairments, including: (PROVIDE EXAMPLES) Loss of previously acquired functional abilities. Memory impairment (reference memory tests).

Sample Psychologist-to-SSA Letter ... Loss of previously acquired functional abilities. Memory impairment (reference memory tests). ... In my opinion, [NAME] is unable to resume any type of gainful employment due to mental impairment. MS is a progressive neurological disorder, and while disability can be delayed ...

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