How recent do medical records need to be for a SSD or SSI disability claim?

To receive disability benefits, how recent do your medical records need to be?

While medical records are not actually required to file a SSD or SSI disability claim, there is no denying that without medical treatment records you will not be able to prove your disability case and receive a disability award. However, more than that, Social Security must also have current medical records to make their determination. For the purpose of a Social Security Disability determination, current medical records are no more than 90 days old.

This does not mean they do not take older medical records into consideration but they cannot use older medical records as the sole source of information for their determination.

If you do not have current medical records, or you have no medical records, Social Security will pay for a consultative examination to get a medical status of your alleged disabling condition or conditions. Consultative examinations can be mental or physical and are performed by independent doctors paid by Social Security, similar to how contract workers are paid for services.

There are often negative feelings about these examinations because they tend to be short and not the thorough checkup many disability applicants are hoping for. Keep in mind they are not designed to actually treat medical problems. Social Security Disability is based more on functionality than actual diagnosed medical conditions, so it is reasonable to assume these examinations are used to determine the severity and limitations of the disability applicant.

In summary, you can have older medical records for a SSD or SSI disability claim but you really need medical treatment for your disabling condition, or conditions, within the past ninety days for a decision. If you do not have current medical treatment, you will be sent to a consultative examination or examinations to get the necessary "recent" documentation for your disability determination.

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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