Overview of Disability

Disability Back Pay

Disability Requirements

Disability Applications

Disability Advice Tips

How long do cases take?

How to win Disability

SSD Mistakes to avoid

Disability for Mental

What if you get denied?

How to file Appeals

Disability through SSA

SSI Disability Benefits

Disability for Children

How do I qualify for it?

Working and Disability

Disability Award Notice

Disability Lawyer Q&A

Disability Conditions List

What is a disability?

Your Medical Evidence

Filing for your Disability

Disability Eligibility

SSD SSI Definitions

Recent Questions

SSDRC Disability Blog

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).

Return to:  Social Security Disability Resource Center, or read answers to Questions

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