I had a client ask me the other day to explain to him the single most important thing to do for a Social Security Disability Claim.
To tell the truth, his question took me by surprise. I’ve never thought of these claims in terms of the one most important issue. I’ve always thought of my cases in terms of many issues all coming together in a successful result.
After I thought about this question, I realized the answer is really very simple. The single most important part of a successful Social Security Disability claim is good medical evidence.
So what do I mean by good medical evidence, and how do you get this kind of evidence?
Definition of disability, according to the Social Security Administration:
“…the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment, which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” 20 C.F.R. §§ 404.1505(a), 416.905(a).
A “medically determinable impairment” is simply a medical condition that results from…”anatomical, physiological, or psychological abnormalities, which can be shown by medically acceptable clinical and laboratory diagnostic techniques. A physical or mental impairment must be established by medical evidence consisting of signs, symptoms, and laboratory findings, not only by your statement of symptoms.” 20 C.F.R. §§ 404.1508, 416.908.
I cannot over stress the importance of these rules.
In sum, what these rules tell us is you need medical evidence to first establish what kind of medical problem you have, and to then show how bad it is. You cannot win your case based only on your own statements about your medical problems. You need medical evidence first!
These rules actually make quite a bit of sense. For example, I could tell my wife right now that my arm hurts very badly. My wife might not believe me because she can see I’m sitting here typing on the keyboard in no apparent distress. What if she could see a broken bone sticking out of my forearm? What if I showed her an X-ray I had taken today showing a displaced fracture? She would then be much more likely to believe I was in pain because my statements about being in pain are now supported by hard proof showing there is something definitely wrong with my arm.
Social Security Disability claims work very much like this simplified example. The strongest claims have supporting medical evidence that is consistent with the claimant’s allegations.
At this point, I hope you agree on the need for supporting medical evidence.
You might be wondering how you get this kind of evidence. Here’s how.
Medical evidence simply means medical records.
You need medical records. You get medical records from your doctors. Medical records are simply your doctor’s way of documenting your complaints, the examination findings, your diagnosis and the course of action your doctor prescribed. I cannot stress the importance of keeping regular doctor appointments. You doctor cannot produce medical records if you don’t go see the doctor. Once you see the doctor, you have to tell the doctor about all of the problems you are experiencing. (I’m going to write an article in the near future about talking to your doctor so keep an eye out.)
If you don’t tell your doctor about the problems you are experiencing, there is no way your doctor will write about them in your treatment records. Furthermore, the doctor will not order testing for problems you don’t talk about.
Finally, try to follow your doctor’s advice, if at all possible.
In closing, I want to give you four real life examples of what will not generate good medical evidence of your medical problems:
- Example 1: “I haven’t been to the doctor for 10 years but my condition hasn’t changed.” In almost all cases, this argument doesn’t work. If you are applying for Social Security Disability today, you need current medical evidence in order to have your strongest claim. I’m not saying your old records are not relevant, but medical conditions do, in fact, change in many situations. The fact that you have not received medical treatment for many years is often interpreted by Social Security to mean your condition must not be bothering you any longer, or your condition has gotten better.
- Example 2: “I saw a doctor 10 years ago and he told me there was nothing more that could be done.” That may be true, but how is your condition affecting you now? Again, you need ongoing, consistent medical treatment covering the entire time relevant to your claim.
- Example 3: “I don’t actually see the doctor. She just calls in prescriptions for me.” I always cringe when I see this situation. I recently faced this very scenario. My client had repeatedly told me she was seeing Dr. Smith (Not the doctor’s real name). When we requested the medical records from Dr. Smith in preparation for my client’s hearing, all we received were numerous notes showing Dr. Smith had called in prescriptions to the pharmacy. These records showed nothing more than the doctor calleing in prescriptions. There was no documentation of the claimant’s complaints or examination findings. There was no way to even know why Dr. Smith was prescribing the medications. This type of record provides very little documentation of your medical problems.
- Example 4: “I don’t talk to my doctor about my disabling problems anymore because he already knows what they are.” This might be the worst kind of records. These records will almost always show that you were at the doctor’s office but had no complaints about the problems that prevent you from working. These records are normally very damaging to your case. If you have a medical problem that is so bad it keeps you from working, it is expected you will talk to your doctor about it.
Again, if you don’t talk to your doctor about a problem you are having, there is no way your doctor will make notes about it. I’ve seen people come into my office with several years of medical treatment records that make hardly any mention of the most limiting medical problems. Talk to your doctor about your problems.
Travis Miller Attorney at Law
I hope this information is helpful. Please remember just because you read this article doesn’t mean I represent you in your case. If you have any questions, leave me a comment below.
Thanks for reading,