When applying for social security benefits, it’s best to have your medical circumstances documented to the fullest extent possible. Gaps in your medical record can lead examiners to create a benefit structure that doesn’t accurately fit your needs or situation. Additionally, missing medical records can substantially lengthen your application process.
Who evaluates your records?
When you apply for SSI or SSDI, you’ll submit an application online, over the phone, or through a Social Security Administration office. From there, the SSA will process your application and send it to Georgia’s Disability Adjudication Services (DAS) agency. Within the DAS, an examiner will contact your doctors to obtain your medical information and make a determination about your disability.
Unfortunately, retrieving your medical records can be a tough process. Medical offices, clinics, and hospitals receive hundreds of records requests every month. For the sake of time, disability examiners may make decisions about your disability without a complete picture of your medical history. They merely need “sufficient enough” evidence to evaluate your claim.
However, “sufficient enough” may not be the best scenario for you. It’s always better to take charge yourself to ensure the necessary information is provided.
Obtaining the records you need
Getting your medical information should be easy—we’ve written before about how you can approach this task. Simply contact your physicians and tell them why you need your records. Notes from your physician should be typed, well-organized, and easy for the SSA’s evaluatory body to read.
Here’s what you’ll need:
These records show that a medical professional has officially diagnosed your condition. If you can, be sure to include documentation of your symptoms and complications associated with this diagnosis. Be sure to gather diagnoses for any and all conditions that you have, as that will weigh into the SSA’s evaluation of your disability.
Don’t forget, the SSA offers benefits for mental illnesses, too.
Emergency Room Visit Logs
If your condition or conditions have resulted in hospitalization, you should obtain a record for each instance. Emergency room visits can show the severity of your condition and its interference with your employment.
The SSA prefers that you try everything possible to treat your condition before applying for social security benefits. Gather documentation of any treatments like surgeries, therapies, medications, etc. Talk these over with your physician, as you will be asked how these treatments affected you and your ability to work.
Gather the results of any tests you’ve undergone, and compare them to the details listed in the SSA’s Blue Book. The Blue Book may also be used to determine what tests may still need to be conducted or more specific information about the SSA’s qualification requirements — for instance, the disability qualifications for epilepsy require a certain number of seizures within a certain timeframe.
Medical History and Background
This information can contrast your capacity to work before becoming disabled with your current limitations, therefore demonstrating your need for social security assistance. Your medical history can also show that your condition, such as a bad back, is getting worse with time.
You may also ask for statements from people who have seen first-hand how your conditions have affected you. These testimonies can be powerful in communicating your needs to the SSA.
Statements from Physicians
Physician statements let your doctors speak directly to the SSA evaluators. Their testimonies can offer a more comprehensive look at your medical history and conditions, providing a clearer picture of your need for social security assistance. Simply ask your doctor for such a statement.
If possible, you might ask your prior employer to write a statement about your conditions and how they interfere with your ability to hold employment.
Your disability attorney knows the ins and outs of the legalities around disability and can speak to your legal qualifications for receiving benefits.
Timely, Accurate, and Sufficient Records
To set yourself up for success at your hearing, make sure the records you gather are as up-to-date as possible, especially if your condition is rapidly fluctuating or worsening. The past six months of records are the most important to the SSA.
Please note that your doctor should be tracking your condition well before you apply for disability benefits.
To prove your condition, you’ll need to provide records from acceptable medical sources. Objective evidence like x-rays, MRIs, and other tests trump the mere opinion of a professional. If a medical professional’s opinion is not corroborated with evidence, the SSA will disregard the opinion.
Allegations and suspicions of your conditions are not enough. If your physician suspects, for instance, that you suffer from arthritis, but has not substantiated that suspicion with x-rays or other tests, the SSA will not find that you have provided sufficient evidence to prove your arthritis. Even official diagnoses from your physician will not be sufficient without testing or other evidence.
Your medical records are especially important if you are applying for retroactive benefits. Retroactive benefits pay out for the months you were disabled before you started the application process for disability benefits. To qualify for retroactive benefits, you must be able to prove you were disabled at least five months before you submitted your application. Retroactive benefits are only available to SSDI applicants.
Get the Help You Need
Creating a strategy for your disability hearing can be overwhelming — the endless gathering of records, filing paperwork, following up with doctors and other parties. You don’t have to do all this alone, and you shouldn’t. With legal representation, you stand a 50% higher chance of being approved for SSI and SSDI benefits.
At Affleck & Gordon, we pride ourselves on getting our clients the help they need. We’ve been helping individuals navigate Georgia’s social security system for decades. We’re ready to help you, too.
If you’ve already been denied, there’s still hope. We’ll guide you through the appeals process and put you in the best position possible to win approval.
There are no up-front costs, and you only pay if we win. Contact us today to arrange your free consultation.
If your Supplemental Security Income claim has been denied, or you’re thinking about filing and don’t know where to start, Affleck & Gordon can help. We’ve been helping people in Georgia just like you for over 40 years. Sign up for a free case evaluation here, or call us (404) 600-0164.