You need medical evidence from your doctor to qualify for disability benefits. However, the Social Security Administration (SSA) imposes strict requirements on the types of information it will accept to support your claim to help ensure that applicants truly suffer from a qualifying disability.
In addition to the detailed medical records necessary to support your disability benefits claim, your doctor might also need to prepare and submit specific SSA forms.
By understanding how the process works and the types of information you and your doctor must provide, you can speed up the application review process and significantly improve your chances of qualifying for disability benefits and avoiding the extensive appeals process.
Which medical records must the doctor provide for your disability claim?
The specific medical records and documents required to substantiate your disability claim will depend on your condition and whether the SSA already recognizes it in its Listing of Impairments as a potentially disabling disorder.
Some of the most common types of medical records required for a Social Security disability claim include:
- Lab reports
- Imaging scans and x-rays
- Surgery records
- Medications and dosages
- Treatment plans
Are there medical records that my doctor should not send to the SSA?
Although you might believe that more information is better, when attempting to qualify for disability benefits, you may hurt your chances for approval by submitting too many records or the wrong types of medical documents.
Your disability claim documentation should never include any records that do not pertain specifically to the condition or disorder responsible for your inability to work.
Submitting unrelated medical records can derail your approval in two important ways. First, it may hinder the approval process if the claim reviewer must root through immaterial documents to find the required information. The reviewer might even lose important data or overlook it.
But, more importantly, sending unrelated medical records from your doctor may raise questions that lead to rejection of your claim.
The SSA looks harder for reasons to deny your disability application than it does reasons to approve it. If you provide documentation about other medical conditions, the reviewer may suspect that your symptoms result from something else — something else that will not qualify for disability benefits.
Is there anything my doctor can do if I do not have a disorder on the Listing of Impairments?
Yes. While the SSA will check your condition, your symptoms and limitations, and the medical evidence your doctor provides against its Listing of Impairments, not having a condition on that list is not an automatic denial.
To help you prove your condition is limiting, your doctor can fill out a residual functional capacity (RFC) assessment form. In this assessment, the doctor will report in detail how your illness affects your ability to function and work.
In preparing the RFC, your doctor must provide a robust level of support for your disability claim. Whether your disability is physical or mental, the RFC must provide a specific, detailed explanation of how and why your condition prevents you from working.
Which doctor should you see for disability benefits?
Although you are free to see any doctor you like, not all medial professionals understand the intricacies of supporting a disability claim. To improve your chances of an approval, a Social Security disability attorney might be able to recommend doctors or other medical professionals familiar with the complex SSA reporting requirements.
Depending on your disability, you should choose a specialist who understands your condition and how it affects your ability to work. It is also important to select a doctor who supports your decision to apply for disability benefits and who is prepared to provide the records you need.
As we have noted, only provide the medical evidence that is specific to your claim when applying for disability benefits. If you see multiple doctors, provide information only from the doctor(s) who treat you for your disabling condition.
However, if you list more than one medical condition as the basis for your disability benefits application, you must provide medical evidence from each doctor who has treated you for each condition.
Will you have to see other doctors to qualify for disability benefits?
Depending on how your application proceeds, you may need to visit additional medical experts or other doctors during the disability benefits application process.
If your medical records are not sufficient for the SSA examiner to substantiate your disability, the SSA may send you to another doctor for what is known as a consultative examination (CE).
In some cases, the doctor chosen by the SSA may not specialize in the condition(s) that affects you. Nor does a CE doctor know you or your medical history. In fact, many people find the CE process counterproductive to their attempt to obtain social security disability benefits.
Do not agree to a CE until you speak to your disability claims attorney about it. If your CE goes wrong, it may prevent you from ever receiving your disability benefits.
How do you request disability records from your doctor?
Never assume that any doctor knows how your condition affects you and your ability to work.
Before you visit your doctor to request disability records, consider talking with a disability benefits attorney from the Law Offices of Ogle, Elrod & Baril, PLLC. Your lawyer can help you prepare a statement detailing your condition to take to your appointment. Then, during your visit, you can talk with the doctor and explain how your disability affects your life.
Because both you and your doctor may be unfamiliar with the SSA’s documentation requirements, a disability claim lawyer may be better qualified to request your medical records. Your disability attorney can help your doctor understand specifically which types of information the SSA needs.
Your lawyer can also provide your doctor with the correct forms to complete for your disability application.
How can a disability attorney help me get information from my doctor?
Social Security disability lawyers know what the SSA needs to approve your disability claim, and they know how to request this information from your doctors. Your attorney can also evaluate your application file, to ensure that it contains everything the SSA will need to evaluate your application.
If you have already applied for disability benefits and received a denial from the SSA, a lawyer can be invaluable in the appeals process.
The Law Offices of Ogle, Elrod & Baril, PLLC provides our clients with assistance in applying for disability benefits. We can provide professional advice and support for preparing and submitting your disability claim application. Our attorneys can also assist you through any phase of the appeals process.