Alternatively, the medical records may sufficiently clarify the present situation but fail to support retroactive benefits because of inadequate longitudinal record keeping. Specialized knowledge of the physical capabilities required for work is beyond the scope of most medical activity. Sometimes one can appreciate these concepts intuitively, eg, that good function of the hands and shoulders and intact ability to stoop, lift, and carry would be very important to an individual without other training who had spent a 20-year career exclusively in the construction trades. However, the treating physician is not expected to have such knowledge, nor to provide conclusions about disability. Relevant radiologic and laboratory data should be forwarded, and any circumstances that compound the applicant's situation should be presented.
Several examples follow for illustrative purposes.
If an individual suffered arthritis, the musculoskeletal examination would be key. Similar clinical information would be needed for an individual with a hemiparesis. Emphasis would be placed on gait, need for an ambulatory assistive device, fine and gross motor function, and communicative or visual dysfunction. Ischemic heart disease would be supported by complaints suggestive of angina or congestive heart failure, results of invasive and non-invasive cardiac testing, physical findings of congestive heart failure, and documentation of myocardial infarction. Evaluation requires accurate information on the clinical process and the time course of its progression.