Social Security Disability Medical Records

All disability decisions are based on the information contained in a claimant’s medical records. If you have been receiving ongoing medical treatment for a physical mental impairment, and your doctor agrees that you are too disabled to work, then you may assume that you will have little difficulty being approved for social security disability or SSI. However, this is not necessarily the case, primarily because it is a social security disability examiner, and not your personal physician, who will decide if your medical condition is disabling, or if you are still able to work in spite of your symptoms.

How is a disability examiner capable of rendering a medical opinion, given that the examiner is neither an M.D. nor a mental health professional? Well, disability examiners do have a certain amount of medical training, and are therefore familiar with common medical terminology and symptoms. More importantly, they are educated in the conditions set forth in the Social Security Handbook that must be met in order to meet the definition of disability as set forth by the Social Security Administration (SSA). In addition, a disability examiner gives greater weight to the opinions of the social security doctor in his unit and the processing unit supervisor than to a claimant’s personal doctor.

Often a disability examiner or doctor will look at the exact same records as a claimant’s treating physician, and interpret them quite differently. For this reason, those applying for disability benefits should ask their doctor for a copy of their medical records and become acquainted with what those records actually say about their condition. Medical records and physician notes that do not include specific information about your symptoms and exactly how they limit your ability to work are not going to do you much good. It is actually fairly common for physicians to fail to provide such detailed information in their notes and patient records, probably due in some part to the fact that they do not work for the SSA and are not aware of what it takes to prove disability.

Because your medical records are so critical to your chances of being approved for disability, you should do everything in your power to make ensure that they are plentiful, detailed and readily available to the disability examiner in your case. Review your medical records so that you know if they support your claim and list activities that you are no longer able to perform due to your impairment. If you retain legal counsel to represent you in your request for reconsideration appeal or your disability hearing, it’s a good idea to work with your attorney or non-attorney rep in gathering your medical records or any statements your physician may be willing to write on your behalf, so that you can be sure that all of the relevant documents make it into the hands of those considering your claim as quickly as possible.

One other thing that can make the difference in getting approved for disability benefits is ongoing medical treatment for your condition—do not stop seeing your doctor after you have filed a claim, even if it has been turned down. Gaps in your medical history will only hurt your case, and make it seem as if your condition was not so serious after all, or at least not serious enough to require continuous care.





For information on Social Security Disability, visit the

Social Security Disability Benefits Resource Center

How is Social Security Disability Awarded

Many individuals who apply for Social Security Disability (SSD) or supplemental security income (SSI) are turned down for benefits. In fact, statistics show that about 70 percent of all initial claims for disability are denied, and those that are denied are no more likely to be approved if they file a new application unless they have significant new medical evidence to add to their file, or if their initial claim was denied on a technicality; e.g., they earned too much income, the total value of their personal assets was too great when they filed the first time, etc.

However, there is a way that individuals who are turned down for disability can improve their chances of being awarded SSD the next time around, and that is to take advantage of the disability appeals process. If your initial claim is denied, you should immediately file a request for reconsideration with DDS (the Disability Determination Services agency that makes all disability decisions for the social security administration). This first appeal is highly likely to be denied as well (about 80 percent of them are), but it is worth the effort because after a reconsideration appeal, a claimant can request a hearing before an administrative law judge (ALJ).

For those who have been denied disability by DDS, this hearing is the best chance they have of receiving a favorable decision. The House Subcommittee on Social Security has reported that over 60 percent of all cases heard by ALJs result in the disability examiner’s denial being overturned, and the claimant being approved for benefits. True, it might take a while for a hearing to be scheduled, particularly in some areas where backlogs can mean a wait of a year or even more. But at least at the disability hearing level the decision is finally out of the hands of DDS and into the hands of a federal court judge who will not, statistics show, be as inclined to rule against those seeking disability.

All disability adjudicators (DDS examiners and judges) decide disability cases based on three basic criteria: 1) the claimant can demonstrate, through medical documentation, that they have a physical or mental impairment; 2) that medical symptoms associated with their condition are severe enough to prevent them from participating in substantial gainful activity; and 3) that their medical condition is ongoing, and has lasted or is expected to last for at least 12 months.

It is impossible to prove any of the three criteria without solid medical evidence, so claimants should take care to supply the social security administration with a detailed medical history that includes names, addresses, and contact numbers for all medical facilities and physicians from which they have received treatment. Without this information, the DDS disability examiner will have difficulty requesting medical records from your physician (s), and this can significantly delay a decision in your case.

After receiving the medical records, the examiner will review them and form an opinion about the claimant’s residual functional capacity (RFC), or what activities the claimant is capable of performing given their current medical condition.

The examiner will then go over the work history that the claimant supplied to social security to see if it is possible to perform a past job or any other type of work to which the claimant may be suited, taking into account their age, education, skill set, etc. For this reason it is critical that those applying for disability provide a work history that is every bit as detailed as their medical history. This should include all places and dates of employment, and all positions/titles held (as well as the job duties associated with those positions) for the past 15 years.

By filing detailed medical and work histories and taking full advantage of the appeals process, disability claimants can greatly improve their chances of, eventually, being awarded social security disability.




For information on Social Security Disability, visit the

Social Security Disability Benefits Resource Center

When should you apply for Social security disability?

This question is routinely addressed by disability attorneys and by columnists. However, the simplest way to answer the question is to state that you should apply for social security disability as soon as your medical condition makes it impossible for you to work, or at least work and earn what is considered to be a substantial and gainful monthly income.

Individuals who are considering whether or not to apply for social security disability will often put off initiating their claim by several months. While this is understandable, it can, given the fact that disability claims filed with the social security administration can take months, even years to result in an award of benefits, be an unwise course of action.

Here is a short of scenarios that may guide when and when not to apply for social security disability.

1. An individual is working full-time: the likelihood is that the gross monthly earned income of an individual who is working full-time will exceed the standard for substantial and gainful income (the actual dollar amount changes each year).

Even if that were not the case, however, the ability to work full time will not serve to substantiate an individual's claim for disability. For these reasons, an individual who is working full time should not choose to apply for social security disability, but, instead, should wait until their physical or mental condition makes continuing working impossible, or make it impossible to work enough (days, hours, weeks, etc) to approach what the social security administration considers a monthly substantial and gainful income.

2. An individual is working part-time and the prospect of working full time does not seem likely due to their mental or physical condition: an individual in this type of scenario should probably make the decision to apply for social security disability. The inability to work at a substantial and gainful income level will substantiate a claim for disability benefits, assuming, of course, that an individual's medical records will corroborate the individual's functional limitations which exist as a result of their medical condition.

What happens if you actually do apply for social security disability while you are working? Then the outcome is one that does not involve a medical evaluation. In other words, social security will deny the claim without reviewing the individual's medical records. In other words, if a person is working and earning a substantial and gainful income, they cannot receive disability benefits no matter how disabling their condition is.




For information on Social Security Disability, visit the

Social Security Disability Benefits Resource Center