Can You Win a Disability Claim if You Have Little Medical Documentation due to a Lack of Health Care?
Can You Win a Disability Claim if You Have Little Medical Documentation due to a Lack of Health Care? Answer: it becomes much harder. If you don't have much documentation, there's a good chance that the disability examiner working on your case will send you to a social security medical exam, known as a CE, or consultative examination. This is done by an outside source, a private doctor who is paid to examine you.
But these exams are just to provide a snapshot, i.e. some amount of documentation that will allow the disability examiner to show that there is recent evidence in the file (not older than 90 days). In other words, it is usually just a way to get the file closed.
Can the results of a consultative exam be used to help win a case? Sometimes, yes. But, usually, if there's little documentation other than the consultative examination report, there won't be enough evidence to get a case approved.
So, what does a person do? The best I can say is try to get seen by someone every three months at the minimum. Without health insurance, this is a tough proposition. In some areas, there are sponsored free clinics. You'd have to check to see if there is something like this where you live.
Claimants in the past have tried other options, such as the use of local hospital emergency rooms as well. Unfortunately, an ER cannot replace an established history with your own treating physician, so if it is at all possible, try to get seen by one periodically. That would mean paying out of pocket and checking into the cost for this, of course. And I realize as I write this that it may be financially impossible. If you have representation, that individual may have suggestions for your immediate area. Good luck on your 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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