Can disability be denied because of not enough doctor visits?
Question: "I was denied disability because I don't go to the doctors enough. Why is that?"
First off, are you sure you were denied disability because of that reason? Disability examiners do need recent medical records in order to make a decision, but it is fairly commmonplace that a person applying for SSD or SSI hasn't been to a doctor recently and, in such cases, they simply send a person to a consultative medical exam.
Now, having said that, let me say a bit about how the process works.
Social Security Disability and SSI disability are won by showing that a person's condition or conditions actually meet the definition of disability used by SSA. That definition states that you must have a disability that lasts at least one full year and which is severe enough to prevent you from working and earning a substantial and gainful income while doing either your past work, or doing any other type of work for which your current mental and/or physical limitations, age, education, and work skills might suit you.
The process of determining disability is much more than simply showing you have a diagnosis. For example, two individuals might have degenerative disc disease but have great differences in severity and functional limitations. For this reason, Social Security, through a disability claims examiner, must evaluate your medical records to determine your functional limitations.
In other words, how does your condition limit what you can do, mentally or physically. For this reason also, SSA must also look at a person's work history to determine what was functionally required to perform the job.
Getting disability involves showing that your case meets the definition of disability. This is why no case can be approved without current medical record documentation. And to get that documentation you need to have records from doctor visits not older than 90 days.
See: How are medical records and work history used to determine a disability claim?
See also: How is the Determination for Disability made by Social Security?
See also: How To Get Disability Through SSDI or SSI Approved
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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