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Does Social Security Disability prefer Current Medical Records for SSDI and SSI claims?
All SSDI (Social Security disability insurance) and SSI (Supplemental Security Income) disability claims go through the same medical determination process. Both current and non-current information can be helpful to an individualís disability determination. In fact, Social Security disability examiners prefer to have at least a twelve-month medical treatment history when making their medical disability determinations.
There are a couple of reasons older non-current medical records are potentially valuable to an individualís disability claim.
Firstly, individuals who have an "expired" date last insured (a DLI, or date last insured, is the last point at which a person was covered, or insured, to receive social security disability benefits) need older medical records to help them establish their onset of disability prior to losing their Social Security disability insured status.
Note: insured status is earned through work credits that result from an individualís work activity prior to their becoming disabled.
Once an individual loses their insured status, they will only be eligible to file for Supplemental Security Income disability program (a.k.a. SSI), which is need-based, and whose monthly disability benefit may not be as high as their SSD, or Social Security disability, benefit may have been.
Secondly, past medical records may help an individual receive back payment for months that they may not have been entitled to they only had current medical records. For example if an individual has not worked at a level that is considered to be substantial gainful work activity for seventeen months prior to filing for disability, they may be entitled to twelve months of retroactive benefits.
However the individual must have a medical treatment history that indicates that the individual was indeed disabled seventeen months ago, meaning "older medical records".
Past medical records can be helpful but are they necessary for a Social Security disability medical determination? Unfortunately, the answer to this question is no. Social Security disability examiners only need current medical records to make their Social Security determinations. Itís logical, considering that Social Security disability is based upon how an individual is currently functioning rather than how they were functioning.
Social Security disability examiners can even make a medical determination based solely upon a one-time consultative examination with a physician, who may not even practice in a medical specialty that addresses the disability applicantís alleged disabling condition.
Additionally, these physicians are only paid to give a quick status of the limitations caused by the applicantís disabling condition rather than an in-depth evaluation of the disability claimantís condition, or conditions, and they rarely lead to an approval.
For this reason, it is better for an individualís disability claim to have current medical records from their treating physician or physicians. There is no way around the fact that an individualís own doctor is more familiar with their conditions and how their condition, or conditions, limit their ability to function, versus a consultative examination physician who has been paid by Social Security and who has never personally met them prior to the consultative examination.
Social Security likes current medical records because it helps them save on the expense of developing medical evidence; it also allows them to make quicker decisions. Although it is good for Social Security for a disability applicant to have their own current medical treatment information, it is also very good for a disability claimant's chances of winning their disability benefits.
Return to: Social Security Disability Resource Center, or read answers to Questions
How Far Back Does Social Security Look At Your Medical Records?
Does Social Security Disability prefer Current Medical Records?
Medical Records That Are Best For Disability Claim
Will SSD or SSI Disability Be Based On Newer Or Older Medical Records?
Medical Evidence for Social Security Disability
Why does it take so long for Social Security to get medical records?
Recent Medical Records for a Social Security Disability or SSI case
Including medical reports with the application for disability
How do medical records and work history determine a disability claim?
What if the disability examiner cannot find all the medical records?
Information on the following topics can be found here: Social Security Disability Questions and in these subsections:
Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI
These pages answer some of the most basic questions for individuals who are considering filing a claim.
Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
How to Apply for Disability - What medical conditions can you apply and qualify for?
Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
What happens if I file a disability application and it is denied by a disability examiner or Judge?
How to Prove you are disabled and qualify to win disability benefits
How do you prove your disability case if you have a mental condition or impairment?
Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
SSI Benefits - who is Eligible and How do I apply