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Doctors how many will I have to see to win SSDI?

Many disability applicants are comfortable with their current medical doctor and wonder if they have to see a bunch of new doctors to win Social Security Disability Insurance (SSDI) or maybe just one SSA doctor. Recently on our disability forum we had a SSDI applicant ask, “To win SSDI benefits how many doctors am I going to have to see and will I have to pay for the medical examinations?”

Winning SSDI benefits with your current medical records and doctor

The great news for many SSDI applicants is that if you have been going to a doctor, which includes all the necessary specialists, and your medical records clearly state your diagnosis, your prognosis, your symptoms and your functional limitations to engage in work you may not have to see any additional medical doctors. Why? Because the SSA relies almost exclusively on your current medical records to determine if you are disabled.

What if you have only seen a primary care doctor and not any specialists? For some conditions this may not matter, but for others, the SSA will expect that you have seen a specialist and may request that you go to one for additional information.

For example, if you have a severe heart condition the SSA would expect that at some point you would have seen a cardiologist and you have been following their treatment plan but still lack the ability to work for at least 12 continuous months. The same assumption will be made with most severe conditions.

What if I have not seen any doctors?

What if you have not been to any doctor? The SSA is likely to claim that you really don’t know if you have the ability to work. For instance, they may claim that you might have the ability to work if you had gotten good medical care and were following your doctor’s treatment plan.

What will they do with your case? Assuming you meet the nonmedical requirements of SSDI: you have sufficient work credits, you are not currently working and making too much money and your condition is expected to last for 12 continuous months, the SSA will request that you see a consultative examiner (C.E.).

Will I have to see a consultative examiner if I have seen a doctor?

There are three reasons the SSA may request that you see a consultative examiner: your medical records do not provide enough information that you are disabled and you cannot work, your doctor does not send the SSA your medical records, or you have seen a doctor but you have not seen the appropriate specialist.

If you meet any of the conditions listed above you may be required to see a C.E. or consultative examiner. This might sound like great news, especially if you don’t have any medical insurance, but the consultative examination does not usually help the claimant win their SSDI case.

Bottom line

Every disability lawyer will tell the disability applicant the same thing. Go to the appropriate doctors, get good medical care, continue seeing the doctor and do not rely on the consultative examination to win SSDI benefits.
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