YOUR MEDICAL RECORDS - WHY THEY DON'T SUPPORT YOUR DISABILITY CLAIM



When you file an application for Social Security disability benefits, Social Security passes your application off to a state agency known as the Disability Determination Service or DDS.  DDS will write to your doctors and medical providers, requesting a copy of your medical files.

What is in those records - or more importantly, what is NOT in them - can be problematic for your disability claim.  To put it bluntly, you may be obviously disabled but your medical records may not come close to proving it.

Here are some statements that will not be sufficient to carry a disability claim to approval:

"This patient is definitely disabled and has been unable to perform any type of work for the past 12 months."  - Signed Dr. ------------------.  Or

"It is my opinion that this patient became disabled on June 10, 2011.  I have advised this patient to stop working.  He is not able to perform any type of work."  Signed Dr. ------------------------

In 20 CFR 404.1527(e)(1), the decision as to whether you are disabled is reserved to the Commissioner of Social Security.  They will not accept a doctor's opinion in the form of the examples above.

Also, records of routine doctor's office visits often don't help because they are much to general and lack detail concerning functional limitations, severity, how long they will last, etc.

A form from your treating physician that gives a "residual function capacity" evaluation can be very helpful in a Social Security disability claim.  This form will provide specific information such as:  how much you can lift and carry, your ability to stand, sit, bend, walk, stoop, kneel, crawl, climb, etc.  The form will address such issues as, "Can the individual perform activities like shopping?"  Or, "Can the individual walk a block at a reasonable pace over rough or uneven surfaces?"

I merely want to get across the idea that your medical evidence must be (a) specific as to your limitations of function, (b) address the severity of your symptoms and (c) establish the duration of your impairment.

I like to use specific forms for the doctor to complete because they ask all the right questions.  Therefore, they gather all the needed information--things that might not be said in 300 pages of office visit notes, lab reports, and insurance filings.


To find out more about my firm and the disability work that we do, click on the link below.

Comments

Post a Comment

Popular posts from this blog

BASIC INFORMATION ABOUT SOCIAL SECURITY DISABILITY

WHAT IS SSDI?   SSDI stands for Social Security Disability Insurance. Since 1956, the US government has required most workers to contribute to a mandatory disability plan administered by the Social Security Administration.  Workers contribute approximately 7.5% of their income (listed as FICA tax on your pay stub) and employers match the amount.  The money goes into a trust account under each worker's Social Security number.  Then, if a disability occurs, the worker can apply for disability benefits. What Are Basic Requirements for Disability?   Assuming a person has worked long enough and recently enough to be covered, here are the basic rules for getting SSDI benefits: at least 1 severe impairment that is medically determinable (provable) the impairment will last a minimum of 12 consecutive months  the impairment is severe enough that the claimant has stopped working full-time What Steps Must You Take To Collect SSDI Benefits?   You ...
Read more

COSTS ASSOCIATED WITH A DISABILITY APPEAL (SSDI)

You decide to represent yourself in your Social Security disability appeal.  What cost can you expect to pay out of pocket? The biggest cost will probably be purchasing medical records.  Yes, you will have to purchase all your medical records.  This is something your attorney/representative would do for you if you were represented.  But if you represent yourself, you pay for all records upfront. Most doctors, hospitals and other providers will charge a set fee, usually called a "retrieval fee" just to locate your records.  Then, they will charge you $1 per page for the first 25 pages, then 50 cents per page thereafter. So, let's say you have 175 pages of records with Dr. A.  You pay $17.50 as a retrieval fee.  Then you pay $25 for the first 25 pages.  Then you pay $75 for the remainder of the records.  Dr. A. has just charged you $117.50 for your records. Not too bad, you say.  But wait.  You must obtain records from every d...
Read more

YOUR SOCIAL SECURITY DISABILITY COVERAGE MAY EXPIRE

Did you know that your Social Security disability program has a shelf-life?  Sure, you know your homeowners insurance comes with an expiration date.  So does your auto insurance.  But Social Security disability? Yes.  Social Security disability is insurance, just like your homeowners, auto policy or life insurance.  You pay for it with taxes (called FICA) deducted from your paycheck.  When you stop working, you also stop paying FICA tax. That begins the clock ticking on your disability coverage. About 4 years after you stop working, your Social Security disability insurance will expire because you are no longer paying into the system.  The date your insurance expires is called "Date Last Insured."  When this date rolls around you can only file a new claim under Title 2 (Social Security disability) if you can prove that the disability began before your date last insured.  It doesn't matter how sick you are, or how unable to work, you ...
Read more