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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 individual’s 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 individual’s 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 individual’s 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. It’s 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 applicant’s alleged disabling condition.

Additionally, these physicians are only paid to give a quick status of the limitations caused by the applicant’s disabling condition rather than an in-depth evaluation of the disability claimant’s condition, or conditions, and they rarely lead to an approval.

For this reason, it is better for an individual’s disability claim to have current medical records from their treating physician or physicians. There is no way around the fact that an individual’s 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.








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These pages answer some of the most basic questions for individuals who are considering filing a claim.

Can you get temporary Social Security Disability or SSI benefits?

Permanent Social Security Disability

What is the difference between Social Security Disability and SSI?

Who is eligible for SSI disability?

Can I Be Eligible For SSI And Social Security Disability At The Same Time?

What makes a person eligible to receive disability benefits?

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?









For the sake of clarity, SSDRC.com is not the Social Security Administration, nor is it associated or affiliated with SSA. This site is a personal, private website that is published, edited, and maintained by former caseworker and former disability claims examiner, Tim Moore, who was interviewed by the New York Times on the topic of Social Security Disability and SSI benefits in an article entitled "The Disability Mess" and also by the Los Angeles Times on the subject of political attempts to weaken the Social Security Disability system.

The goal of the site is to provide information about how Social Security Disability and SSI work, the idea being that qualified information may help claimants pursue their claims and appeals, potentially avoiding time-consuming mistakes. If you find the information on this site helpful and believe it would be helpful to others, feel free to share links to its homepage or other pages on website resource pages, blogs, or social media. Copying of this material, however, is prohibited.

To learn more about the author, please visit the SSDRC.com homepage and view the "about this site" link near the bottom of the page.