Medical Evidence Is Critical To a Disability Claim

Medical evidence is at the heart of every successful Social Security Disability or SSI Claim

Of all the factors Social Security considers when evaluating a disability claim, one trumps them all: medical evidence. There is virtually no way to get an SSDI or SSI claim approved without medical evidence that supports your allegations!

In fact, it is a waste of time and effort. And the only way to get strong medical evidence is to receive medical treatment. After your treatment, it is critical that the correct medical evidence is obtained and presented in a manner that Social Security requires.

What type of medical evidence is needed to support my Social Security Disability claim?

One of the key questions in a disability claim is, “What type of medical evidence is needed?” The answer to that question varies considerably and is determined based on the nature of your medical conditions. For example, if you are filing disability benefits due to your COPD, there are specific tests that are required to support a finding of “Disabled” due to your breathing disorder.

If your claim is primarily related to mental health conditions, it is imperative that you are receiving ongoing medical treatment from a psychiatrist or psychologist and that you are compliant with the recommended course of treatment (medicine, therapy, doctor’s visits, etc.). If you are not receiving medical treatment, Social Security may believe, “Well, she must be all better – she is not even getting medical treatment!” The facts of your situation may limit your ability to receive medical treatment: “I don’t have medical insurance” is the number one excuse; “I don’t have any funds to pay for my tests” is the number two excuse; “I don’t have transportation to get to the doctor” is the number three excuse. And there are many others. However, Social Security’s job is not to evaluate the credibility of your excuses; their job is to evaluate your medical evidence! If there is no medical evidence, there is no basis upon which to approve your claim.

The bottom line is you need to find a way to get medical treatment, whether this means visiting a community health center, a Vocational Rehabilitation facility, an Emergency Room, or borrowing funds from family and/or friends. You must make getting medical treatment a top priority – and get it done.

How many times do I need to go to the doctor?

Another key question we hear often is, “How many times do I need to go to the doctor before Social Security will approve me for disability benefits?” The answer, again, varies. For example, if you have terminal cancer, one visit to an oncologist will confirm this diagnosis and will likely be sufficient for approval for disability benefits. However, if you suffer from mental health disorders, it can take years of medical evidence to build up the credibility of your claim in order for it to be approved. Again, the facts of your case will determine what type of evidence is needed for approval.

What medical evidence is considered relevant?

Determining what medical evidence is relevant to a disability claim is more “art” than “science.” There is a tremendous amount of judgment that needs to be applied. In general, more (medical evidence) is better than less (medical evidence). However, in certain cases, employing a strategy of “piling it on” can backfire. We see this often and it makes the disability claimant appear to Social Security to be a hypochondriac, or an exaggerator.

For example, if you have severe kidney disease supported by vast medical evidence, and your past relevant work was masonry work, and you are 59 years old, there is little benefit to introduce the fact that you also suffer from mild depression, or sprained your wrist, or sprained your ankle – this information tends to distract the adjudicator from your primary disabling condition, your kidney disease. Also, this information tends to lengthen the time it takes to get your claim adjudicated – if they have to review 20 medical records instead of 2 medical records, this can literally extend your timeline by months.

Relatedly, “old” medical evidence does not work! Every day, prospective clients will tell us, “Well, I was hospitalized in 1987 for two weeks due to a car accident.” Whatever happened in 1987 is not relevant to your disability claim today. The question is not, “Were you disabled in 1987?” The question is, “Are you disabled today?” And what medical evidence do you have to prove it? It can be terribly damaging to a claim to introduce superfluous medical evidence because it distracts the adjudicator and, frankly, can upset them because you are wasting their time with information that is not relevant to your claim. But, again, it is a balancing act – and judgment informed over decades of winning disability claims can be a huge benefit to your case.

We can help you get approved for disability benefits

Obtaining and presenting relevant medical information is a key reason why you should consider hiring a disability attorney or non-attorney disability expert. A capable and qualified disability professional will be able to guide you to ensure you have the evidence needed to support your claim for disability benefits.

To discuss your disability claim with an expert, contact us now. We can help you determine whether you have sufficient medical evidence to develop a winning claim – and what steps are needed to win.

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