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SSDI - So where's my doctor?

The SSA does not provide doctors to SSDI applicants


Recently on the Social Security Disability Insurance (SSDI) forum we had a claimant state they could not wait for the Social Security Administration (SSA) to send them to a doctor so they could get the treatment they so desperately need. This type of statement is common for disability claimants who have not worked for some time, do not have insurance but have a serious medical condition and need medical care.


The SSA does not give you medical care


It’s disappointing for many applicants who need medical assistance but the SSA does not provide medical care for SSDI or SSI applicants. So what does the SSA expect you to do? In an ideal world you would get the proper medical care BEFORE you applied for benefits. Getting great medical care, in fact, is critical to winning SSDI or SSI because the Social Security Administration (SSA) will use your current medical records to determine if you are disabled.

What type of medical care is offered by the Federal Government?


Although ObamaCare is likely to eventually usher in some type of medical care for every one (although even then it is unlikely it will be great or readily available to everyone) right now the only two options are Medicare and Medicaid.

It is possible to qualify for both Medicaid and Medicare without getting SSDI or SSI but there are very stringent requirements which are difficult for many claimants to meet.

Will I get medical care if I am approved for SSDI or SSI?


Yes, if you get Social Security Disability Insurance you will get Medicare 24 months from the date of your disability. If you get Supplemental Security Income benefits you will get Medicaid, in most states, at the time you are approved. Some states do not automatically approve Medicaid with SSI and others require you to complete a separate application. Talk to the SSA about your state’s regulations and rules.

How will I win SSDI or SSI if I don’t have recent medical care?


The sad truth is that if you have not recently seen a doctor and you do not have good medical documentation it will be almost impossible to win benefits. The SSA will send you to a consultative examiner if they have insufficient records to evaluate your disability and whether you can work, but these reviews are generally very cursory and seldom result in a claimant winning SSDI or SSI benefits.

Can I get free medical care somewhere?


There are free mental health centers in some cities and some claimants go to the emergency room when they are really sick, but another option is to periodically visit a minor emergency center for treatment. Over time with enough visits you could establish good documentation that you are severely disabled.

Can a lawyer help me if I have not seen a doctor?


Many lawyers will not take a claimant’s case if they have not seen a doctor. Why? Because they know that the chance the applicant will be approved is very low. Some lawyers, however, may take the case especially if they know the claimant is likely to be approved if they can gather the right information. Talk to a lawyer about your options if you do not have medical care.
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