Will SSD or SSI Disability Be Based On Newer Or Older Medical Records?

Social Security Disability determinations are based upon newer medical records...if that is all that Social Security has available to them. This means that disability examiners must have new current medical records to make their disability determinations, but not necessarily older records (though older medical records are used to determine a claimant's onset, i.e how far back their disability began, which can have a definite impact on how much back pay the claimant is eligible to receive).

Social Security Disability examiners, ideally, like to have more medical records and a longer medical history to base their medical determination upon. Social Security actually prefers at least a twelve-month medical history or more (assuming that the records exist and can be located) to evaluate the severity of an individual's disability or disabling condition.

Older medical records, along with newer medical records, help establish how long an individual has had their disabling condition as well as the severity of the condition. Individuals who have a long medical treatment history usually have more detailed information as to how their disabling condition has prevented them from performing substantial work activity (SGA is a monthly earnings amount that Social Security considers to be at a level that self'sustaining).

Older records are particularly useful if an individual has not performed substantial work activity for quite some time prior to filing for disability. Why? Because it may enable their disability to be established prior to their date last insured, or DLI. DLI is the date that they no longer had disability insured status.

Insured status is earned though work activity and in order to be insured for Social Security Disability an individual must be "fully insured" and "disability insured". To be fully insured, an individual must have earned at least one quarter of coverage per year from the age of twenty-one to the year they became disabled and they must have worked twenty quarters out of the past forty possible quarters.

This basically means that an individual must have worked five out of the last twenty years in order to have disability insured status. Once an individual has become insured, howver, it is not indefinite, which means it could expire if an individual has not worked.

In addition to allowing earlier onset of disability, older medical records may enable a disability claimant to receive up to twelve months retroactive benefits from the date they filed if they have been out of work at least seventeen months (there is a five month waiting period that Social Security never pays disability benefits).

In a nutshell, Social Security Disability benefits may be based upon both old and new records. And some individuals may receive Social Security Disability or SSI benefits strictly because they had old medical treatment notes for Social Security to use.

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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