How can I win disability if I don't have health insurance and can be seen by a doctor?

It can be more difficult to win disability benefits if you don't have health insurance simply for these reasons:

1. Social Security Disability and SSI determinations are based solely on the information found in a claimant's medical records.

2. Although older medical records are important for the purpose of establishing a favorable onset date (an onset date is when your disability is considered to have started), which itself is very important for establishing how much a claimant can receive in disability back pay, newer and recent medical records are very important for establishing the fact that a claimant currently meets the social security definition of disability.

Unfortunately, not having health insurance at some point is a very common situation for many, if not most, applicants for Social Security Disability or SSI. In fact, it may be the case for the great majority of claimants.

Can you still win disability if you don't have health insurance and aren't able to go to the doctor much? Yes, and many claimants do. How do they do this? In some instances, by utilizing alternate means of obtaining medical treatment such as free clinics and by visiting emergency rooms.

However, when a claimant's case is reviewed by a disability examiner (examiners make decisions on disability applications and reconsiderations) or disability judge, if no current medical treatment is in the file, the claimant will typically be sent to a social security consultative medical examination. The purpose of this examination is to provide a recent snapshot of a claimant's condition and to allow social security to make a disability decision on a case.

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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