Social security is not always successful in obtaining all of a claimant's medical records

Someone wrote and said that after one's medical records have been gathered...the trick is for social security to actually look at them. As a former examiner, I can definitively state that social security does look at everything they gather. In fact, disability examiners (the individuals who render decisions on claims at the disability application and reconsideration appeal levels) have a clear incentive to do so because they have case processing unit supervisors who check to see that every "i" is dotted and every "t" is crossed. Missing something in the MER as it is called, or medical evidence of record, is not something that examiners are typically allowed to do.

However, while a claimant can be relatively sure that social security will look at and consider everything that is obtained, how that information is evaluated is a different matter entirely. In actuality, sometimes the trick is for social security to accord the proper significance to medical records. This is true in cases where pain plays a prominent role, or where many meds are being taken that, while treating the individual's major symptoms and complaints, cause side effects that (such as fatigue and difficulty with concentration) that can make it nearly impossible to engage in work activity or other types of ADLs (activities of daily living). And, of course, it goes without saying that the social security administration has a long track record of not giving proper consideration to things like pain.

Will social security look at your medical records? Of course. Each disability examiner--and, quite likely, his or her unit supervisor and unit medical consultant--will review everything in a claimant's medical records which has been successfully obtained.

But there's the rub, as it were. Social security is not always successful in obtaining all of a claimant's records. Why does this happen? Sometimes because...not all of a claimant's medical treatment sources have been disclosed.

On this note, I've seen cases in which claimants have failed to disclose a particular treatment source at the application level and the reconsideration level, and then only mentioned, prior to a hearing, that they had received treatment from a Doctor X at facility Y. Which, of course, was mind-boggling. How did the individual ever think that their case could be properly evaluated without social security being informed of all their treatment sources?

I can only theorize that a small percentage of claimants have the mistaken belief that the social security administration can look into a computer database that automatically reveals everywhere they've been for medical treatment. In other instances, it's probably true that the claimant overlooked a medical treatment source when filing their claim, and then never thought of the issue again--until it came up with their disability attorney or non-attorney claimant's representative.

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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