Social Security Disability Resource Center

What happens if the Social Security disability examiner cannot find all the needed medical records?




 
If the disability examiner cannot find all the needed medical records for a Social Security Disability or SSI Case, what happens?

Answer A): If the examiner cannot find medical records that show treatment for a particular condition, the examiner will probably have to schedule a CE, otherwise known as a consultative examination, and often referrred to as a social security medical exam.

Answer B): If the examiner cannot find current medical records, the examiner will also probably have to schedule a CE. This is because the social security administration requires that the decision on the disability claim is based on at least some current information. Current information is defined as information that is not older than 90 days. Why is current medical information important? Because to establish disability benefits, there must be sufficient proof that the claimant currently has limitations that are significant enough to prevent work activity.

In addition to this, the case must be strong enough for the disability examiner (or the judge if the case is at the hearing level) to believe that the claimant's state of disability will not be "durational". Durational denials on SSDI and SSI claims happen when the claimant is considered to meet the Social security definition of disability but it is also believed that the claimant's condition will resolve or improve to the point of non-disability within 12 months.

Now, can you be denied for SSDI or SSI if social security cannot find all your medical records, or cannot find certain records? There is no rule for this; however, as we've indicated, the ability of the examiner to approve a case depends on what evidence is available to establish limitations that rule out work activity.

The more evidence the examiner has, the easier it will be document the claimant's RFC, or residual functional capacity (what a person can still do, in spite of their disability, or various disabling conditions). Less evidence can translate to a diminished chance of receiving a social security benefit award.

Note: If the only evidence available to a disability examiner is the report of findings from a CE that has been scheduled by a disability examiner, then the outlook is very poor for the disability claim being approved. The medical exams that are scheduled by social security tend to be very brief, simple exams that do not provide much more information to the disability examiner than would be the case for a routine visit to one's doctor.

Adding to this, the independent physician who is paid by SSA (social security administration) to conduct the exam will probably know next to nothing about the claimant's medical history and, therefore, they will have nothing to relate their "ten minute session" with the claimant to. By and large, the only purpose for the consultative examination is so the disability examiner can state that they have current medical evidence in the file before a decision is made and the file is closed. Typically, of course, when there is little more in the file than the report from the CE, the outcome will be that the case is denied.

Claimants who file for disability very much need to have current treatment and also need to maintain regular treatment while their disability application is pendingn or their disability appeal is being reviewed. And, at the time of applying for disability, the claimant should make a strong effort to provide detailed information about their treatment sources. Claimants who apply at a social security office should never simply assume that SSA will be able to locate a Dr. Johnson on carver street.

Claimants can make the process easier and more complete by getting a list of all their various doctors before their disability application interview is done. The list should include all contact information as well as names of doctors. It should also include every single doctor and clinic from as far back as the claimant believes their disability may have begun.

This is important so that the earliest possible onset date can be determined which will potentially mean receiving a higher amount in Social security or SSI back pay.

It could also mean getting one's disability established before their coverage for social security disability expires (all social security disability cases have something known as a DLI, or date last insured, and this is the date up until which a person is covered for the program).








  • Index of Social Security Disability SSI Questions and Answers

  • 56 Answers to Social Security Disability SSI Questions







  • SSDRC Homepage:

    Social Security Disability and SSI Resource Center



    The Most Basic questions about Getting Disability Benefits

    Social Security Disability and SSI Back Pay Benefits

    Social Security Disability SSI and whether or not you can work

    How long does it take for Social Security Disability or SSI?

    Social Security Disability SSI Awards and Award Notices




    Tips, Mistakes, How to Qualify, and How to Win Disability

    Tips and Advice for Social Security Disability and SSI Claims

    Common Mistakes to avoid after being denied for Disability

    Disability Qualifications and How to Qualify for Disability Benefits

    Winning Social Security Disability or SSI, How to Win




    Denials, Appeals, and Getting a Disability Lawyer or Representative

    What you should know about Social Security Disability and SSI Denials

    Social Security Disability and SSI Appeal Process - How to file appeals

    Questions about Disability Lawyers and Hiring a Disability Attorney




    Various Types of Benefits including SSI, Mental, and Child benefits

    SSI Disability Benefits, Questions and Answers

    Social Security and SSI based on Mental Disability

    Social Security Disability or SSI Benefits for Children

    Disability Benefits through Social Security




    Information to start with regarding Disability Claims

    An Overview of Social Security Disability and SSI

    What is considered a Disabling condition by Social Security?

    The Disability Requirements to be eligible for SSD and SSI Benefits




    Filing for Social Security Disability or SSI Benefits

    Social Security Disability and SSI Applications

    Social Security Disability SSI List of Conditions and Impairments

    Social Security Disability SSI: Medical Evidence and Records

    Filing your claim for disability benefits

    Eligibility for receiving disability benefits




    Resources on this site

    Social Security Disability, SSI Terms and Definitions

    Previously answered questions regarding SSD and SSI



    The SSDRC Disability Blog




    For Individuals living in North Carolina

    Disability in North Carolina

    North Carolina Disability Lawyer

    Getting disability in North Carolina








    Related pages:

    What does a Social Security Disability Examiner do?
    Can I Talk To the Disability Examiner Working On My Case?
    How Does A Social Security Disability Examiner Determine a Personís Functional Limitations?
    What happens if the Social Security disability examiner cannot find all the needed medical records?
    How long does it take for an examiner to review a disability case?
    Will the the SSA Examiner Call or Contact me about my Social Security Disability or SSI Claim?
    What tools are used by a Social Security Disability Examiner to Make a Claim Decision?
    After you file for SSD, the Disability Examiner may contact you for additional information
    Not enough accumulated quarters for disability, what do I do?
    Can I get Retroactive SSI Disability Benefits?



    Information on the following topics can be found here: Social Security Disability Questions and in these subsections:

    Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI


    These pages answer some of the most basic questions for individuals who are considering filing a claim.

    Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
    How to Apply for Disability - What medical conditions can you apply and qualify for?
    Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
    What happens if I file a disability application and it is denied by a disability examiner or Judge?
    How to Prove you are disabled and qualify to win disability benefits
    How do you prove your disability case if you have a mental condition or impairment?
    Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
    Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria