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Based on Greg's experience, the key to approval is the medical evidence supplied by the physician. I'm in the application process now, and here are my thoughts on this. I'll let you know if they are correct after I hear from SSA ;-). The average physician probably doesn't know what is required by SSA, does not know of the free SSA publications like "Disability Evaluation Under Social Security" (SSA Publication no. 64-039) containing instructions to physicians, and may not be inclined to read it anyway -- the book is 200+ pages in length. So someone other than the physician must research the disability criteria and guide the assembly of medical evidence for the application. There are a few pages in the book that outline requirements for medical reports. In general, reports should include * medical history * clinical findings (results of examinations) * laboratory findings [there are no lab tests for PD] * the diagnosis * the prescribed treatment, with response and prognosis * the physician's opinion, based on the above medical findings, as to what the claimant can still do despite his/her impairment(s), in terms of general work-related capabilities (e.g., handling objects, lifting, understanding and carrying out instructions). This book is available for the asking from Social Security Administration, Office of Communications, Public Information Distribution Center, P.O. Box 17743, Baltimore, MD 21235 as are a few more I haven't seen: Answers for Doctors and Other Health Professionals(Pub. No. 64-042) Evaluating Disability Under Social Security (Pub. No. 64-045) Social Security Disability Public Information Products List (Pub. No. 64- 065) The SSA booklet "How To Apply For Social Security Disability Benefits," on-line at http://www.ssa.gov/disability.html, outlines the five-step process to determine disability: "1. Are you working? If you are and your earnings average more than $500 a month, you generally cannot be considered disabled. "2. Is your condition severe? Your impairments must interfere with basic work-related activities for your claim to be considered. "3. Is your condition found in the list of disabling impairments? We maintain a list of impairments for each of the major body systems that are so severe they automatically mean you are disabled...." Once the presence of a listed condition with the indicated severity is established, there is no need to go on to steps 4 and 5. Further details on this are given in Social Security Ruling #SSR 82-53 at http://www.ssa.gov/OP_Home/rulings/di/01/SSR82-53-di-01.html The listing of impairments, which comprises the bulk of the 200+ page book, is at http://www.ssa.gov/OP_Home/cfr20/404/404-ap09.htm There is a brief entry in the listing for PD: "11.06 Parkinsonian syndrome with the following signs: Significant rigidity, bradykinesia, or tremor in two extremities, which, singly or in combination, result in sustained disturbance of gross and dexterous movements, or gait and station." So the physician's report must include medical evidence of the presence of the above diagnosis and of its "signs" and indicate the appropriate severity. There's no definition, however, of "significant" or "sustained disturbance". Nothing is said explicitly as to whether control of symptoms by medication is disqualifying. This is explicit for certain other neurological disorders, however. For petit mal epilepsy a seizure more than once a week despite 3 months of prescribed treatment is qualifying. For myasthenia gravis there must be "significant difficulty with speaking, swallowing or breathing while on prescribed therapy." This suggests to me that with PD the presence of "significant" response fluctuations to medications is an indicator of qualifying severity. There is nothing mentioned about fatigue from PD. If fatigue is an important impairment to working, then perhaps evidence needs to be given indicating the similarity to some other condition on the list in which fatigue is an explicit and crucial part, such as MS. For MS to qualify there must be "significant, reproducible fatigue of motor function with substantial muscle weakness, on repetitive activity, demonstrated on physical examiation..." This sounds like the PD neurological test where you are asked to repeat opening and closing your fist. I didn't see any reference to overall fatigue preventing you from getting through the day -- but I was too tired to read the whole thing. There are special requirements for documenting mental, including affective, disorders -- too much to go into in this message. I hope this helps. Phil Tompkins Hoboken NJ age 62/dx 1990