Revisions.
Free and unlimited before you file: corrections, citations, your firm's form, clearer wording, anything I missed in the record. Conclusions move only when the record does.
FOR ATTORNEYS AND REPRESENTATIVES
An RFC opinion built to survive 404.1520c, from a source who has done thousands of VA disability exams.
Send the electronic folder. I read every page, tell you within 24 hours what the record supports, and deliver a signed, exhibit-cited medical source statement and narrative within 24 hours of your go-ahead. Flat fee, invoiced to the firm or paid by the claimant, never contingent.
Medical Source Statement and Narrative Opinion
Function-by-function assessment
Lifting and carrying: 10 pounds occasionally (Ex. 7F/12, 9F/3)
Sitting: 30 minutes at one time, 4 hours total (Ex. 4F/22, 11F/8)
Off task: 15% of the workday (Ex. 9F/3, 12F/15)
David Protaziuk, MSN, APRN, FNP-C
What to send.
David Protaziuk, MSN, APRN, FNP-CFormer VA disability examiner, three years, thousands of examsIllinois license 277002570
The electronic folder as a PDF, or the medical exhibits (F section) at minimum
Hearing date, if scheduled
Alleged onset date, date last insured, and the date the claim was filed
Your preferred form: your firm's RFC questionnaire, an SSA-style medical source statement, or mine
The claimant's phone number or email for the written functional questionnaire
Anything you want addressed specifically: a consultative examination, a prior ALJ decision, a particular listing
Timeline against the five-day rule.
- 1
Hour 0: file received, receipt confirmed.
- 2
Within 24 hours: pre-screen by phone or short email, your choice: what the record supports, what it does not. No opinion exists until you approve.
- 3
Within 24 hours of your go-ahead: record review complete, claimant questionnaire returned, opinion signed and delivered.
- 4
Hearing minus 5 business days: your deadline under 20 CFR 404.935. Send the file as soon as the hearing is scheduled; the earlier it arrives, the more time the claimant has to return the questionnaire.
What the opinion contains.
- 1
Scope and basis. What I was asked, what I reviewed, that I did not examine the claimant, that my fee is flat and not contingent.
- 2
Medically determinable impairments documented in the record, each with the exhibit and page.
- 3
Treatment course and response.
- 4
Function-by-function assessment: lifting and carrying, standing and walking, sitting, postural, manipulative, environmental, need to elevate legs or use an assistive device, time off task, absences, and the mental component in combined claims. Each limit followed by its clinical basis and citations.
- 5
Evidence that cuts against the limitations, and how I weighed it.
- 6
Onset and duration.
- 7
Statement of the author, signature, license and NPI.
Appendices: index of records reviewed, the claimant's questionnaire, credentials and licensure, fee disclosure.
What I take and what I do not.
I TAKE
Adult Title II and Title XVI claims at any stage, most often at the hearing level. Physical impairments. Combined physical and mental impairments where the mental limitations can be grounded in the treating record. Files in English. Claims where the record contains objective findings that a limitation can rest on. Claims filed on or after March 27, 2017 for acceptable-medical-source status; earlier filings accepted with the status difference stated in the opinion.
I REFER OUT OR DECLINE
Mental-only claims (I will tell you if I know a source). Childhood SSI claims. Files with no objective findings at all, because an opinion that rests on complaints alone will not survive the supportability question and I will not sign one. Requests for a specific conclusion in advance; I state what the record supports.
After the opinion is in the file.
Interrogatories.
Written responses to interrogatories from the judge or counsel are included at no charge, returned within 24 hours.
Addenda.
New evidence after delivery, such as new imaging, surgery or treating notes: a written addendum, signed and dated after the new records, at no charge, within 24 hours.
Testimony.
Telephone testimony at the judge's request is available. Ask when you send the file and I confirm availability and the hourly rate in writing.
What the courts have said about opinions like this one.
Four decisions that shape how I write.
Nolen v. Kijakazi, 8th Cir. 2023
A check-box form on which the source left blank the section asking what objective findings supported the assessment: the court called it a "bare, formulaic conclusion" that "presumptively warranted little evidentiary weight." Every limitation I state carries its findings and its page cites.
Drumgold v. Commissioner, 4th Cir. 2025
The ALJ credited two non-examining reviewers because they backed their conclusions with record citations and were consistent with the overall record, and the court held that "merely attaching a label does not bypass consideration of the opinion's supportability." Citations and consistency, not titles.
Jones v. Dudek, 7th Cir. 2025
A source's statement that the claimant could work "about 20 hours per week maximum" was treated as a statement on an issue reserved to the Commissioner, which the judge need not evaluate. I state functions, hours and pounds, never the ultimate question.
Punzio v. Astrue, 7th Cir. 2011
On opinions obtained for the claim: "How else can she carry this burden other than by asking her doctor to weigh in?" The purpose for which an opinion is obtained is not a lawful reason to reject it; its substance is what gets tested.
Case summaries are mine, not legal advice. Read the decisions.
If the claimant's care is at the VA.
SSA's own manual tells adjudicators that "as a matter of policy, the VA does not permit its physicians and psychologists to provide this type of opinion" (POMS DI 22505.007). A veteran whose care is entirely at the VA arrives at the hearing with hundreds of pages of VA notes and no medical source statement, and no way to get one from a treating source. I spent three years inside the VA examination system and I read VA records every working day. These are the files I know best.
"As a matter of policy, the VA does not permit its physicians and psychologists to provide this type of opinion."
Fees.
| Service | Fee |
|---|---|
| Medical source statement plus narrative opinion | $499 flat |
| Revisions before filing | Free, unlimited |
| Addendum after new evidence arrives | Free |
| Written interrogatory responses | Included |
| Pre-screen of the record | Free |
One fee. Everything after delivery is free: revisions, addenda for new evidence, interrogatory answers.
Send a file for a free pre-screen.
Fill in the form and I reply within 24 hours with the secure sending instructions, or skip the form and email david@claimmedicalopinions.com directly.
FAQ for attorneys
Who pays, the firm or the claimant?
Either. Firms usually advance the fee as a case cost. If the claimant pays, they pay by card and I send the receipt to both of you. The fee and who paid it are disclosed inside the opinion.
Will the opinion say the claimant is disabled?
No. That finding is reserved to the Commissioner and stating it would reduce the weight of everything else in the document. The opinion states functional limitations, their basis, onset and duration.
Can you complete our firm's RFC form?
Yes. I complete your form and attach the narrative. Every box I tick on the form is explained in the narrative with citations.
What if the record doesn't support what we hoped?
I tell you at the pre-screen, at no charge. Sometimes the record supports a different set of limitations than the ones you asked about, and I say which.
Judges prefer physician signatures. Why should we retain a nurse practitioner?
Some adjudicators still do, and you should know the objection exists. The regulation does not rank credentials; it tells the judge to weigh supportability and consistency, and the published decisions that discount nurse practitioner opinions do so because the opinion was unexplained or contradicted by the source's own notes, not because of the credential. My answer to the objection is on every page of the opinion: the findings, the citations, the contrary evidence addressed, and three years of VA disability examinations behind the reasoning.
Does the all-evidence rule affect this?
Yes, and it is why the pre-screen comes first. A completed opinion must be submitted whether or not it helps (20 CFR 404.1512). So I do not write anything until the pre-screen tells you what the record supports and you approve. The pre-screen is a consultation, delivered by phone or in a short email at your preference.
Do you revise the opinion if we ask?
Before you file, yes, free and without limit: citations, format, your form, wording, and anything I missed in the record. What I do not do is change a conclusion on request. Under the all-evidence rule a completed opinion must be filed, so a second version with different conclusions would sit next to the first one and damage both. That is why the substantive discussion happens at the pre-screen, before anything is signed.
What about our disclosure duty when we refer a claimant to you?
20 CFR 404.1740(b)(5) requires a representative to disclose in writing, when the opinion is submitted, that the representative referred the claimant to the source. Every opinion I write states who requested it and who paid for it, which makes that disclosure a sentence.
Is your fee subject to SSA fee authorization?
No. A medical report fee is an out-of-pocket case expense, not a representative fee, and SSA does not authorize it (HALLEX I-1-2-5). How it is advanced and recovered is governed by your fee agreement with the claimant.
Do you review the whole folder or just the medical exhibits?
The whole folder when you send it. The non-medical exhibits (work history, function reports, prior decisions, the consultative examination) are where the consistency analysis comes from.
How do you handle the claimant questionnaire?
A written functional questionnaire sent to the claimant by email or mail, returned to me, attached as an appendix. It is not an examination and I do not describe it as one. Where the questionnaire and the record disagree, the record controls and I say so.
Are you licensed in our state?
I am licensed in Illinois with full practice authority. This is a records-based opinion for a federal benefits claim. I do not examine, diagnose, treat or prescribe for claimants, and the claimant questionnaire is written, not a telehealth visit. SSA's own guidance for verifying a source's credentials looks to the license held, not to the claimant's state (POMS DI 22505.003).