Tuesday, August 23, 2011

How important are medical records to a Disability case before SSA?

Social Security requires that you provide medical documentation of your disabling condition(s). If you were getting regular medical care and then lost your insurance and had no means of obtaining medical care, SSA Regulations require that DDS  obtain a Consultative Examination(s) of your conditions. During the most recent years, these have increasingly been performed at "mills" by medical care providers who do not see you in their practice, many do not have a practice and only perform DDS and Workers Compensation evaluations. It is my opinion that Claimants are not served well by these evaluations when done by these groups. I have numerous clients who say that they were not even touched by the examining clinician. There is no way that I am aware of that a clinician can comment accurately about muscle spasms if they do not touch the patient! With this  in mind, it is essential that you have consistent medical records.
FIND a free clinic or a sliding fee scale clinic; APPLY for Medicaid so those medical care providers who do provide treatment and evaluations during this determination period, will be able to bill Medicaid/Medicare for your services when you win. Major medical centers and medical school clinics provide exceptional documentation of disability cases.
The Social Security Administration Regulations require that your medical records meet certain standards. These are not my standards; these are the Rules: generally very little evidentiary weight is given to the records of an LCSW who is not having their records and case work supervised by a PhD in psychology, a LPC (Licenced Professional Counselor), or a MD with a psychiatric specialty; SSA usually will give little weight to the medical opinions of a Nurse Practitioner unless counter signed by a physician. A General Practitioner or Family Practice physician's opinions of mental disease or some other highly specialized disease process, such as anxiety and depression, cancer, diabetes, neuropathy, stroke, cardiac conditions,etc, are given little weight if the symptoms do not require the referral to a specialist You must recognize these limitations when you are seeking medical documentation of your condition(s). I cannot tell you the number of Claimants who have to accept a much later onset date than when they first became disabled by a condition because the Claimant continued to be seen by a physican/medical care provider that SSA does not consider to be adequate to provide treatment and/or diagnosis. Many times, once referred ot the specialist, the Family Practiiotner "supervises" the care prescribed by the specialist, and SSA will accept those records.

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