Medical Evidence for SSA Disability
What information will be in my medical file?
Every day on the forum we get questions from SSDI and SSI claimants asking how they can prove that they are disabled and unable to work. The answer is always the same- you must have great medical evidence (and meet the nonmedical requirements), but what is medical evidence and what is a disability lawyer looking for when they review your medical files?
The first step for the disability lawyer when they review the SSA exhibit file for the SSA claimant is to determine what information is available from each treating source or doctor. If a SSI or SSDI claimant has been getting medical care from a doctor, but there is not information in the SSA exhibit file, it is up to the SSDI disability lawyer to contact that doctor and get the most recent medical information.
Generally medical evidence includes medical records that were created for treatment, reports created to substantiate a disability, summaries about the claimant written by a treating physician and evidence of medical opinion by a doctor.
How does the Administrative Law Judge view medical evidence?
The administrative law judge will give the most weight to medical records which were generated from treatment. Unfortunately, these do not always clearly state the functional limitations a claimant may have to work. But the good news is that if a claimant has evidence they have been hospitalized multiple times or they have been forced to see a doctor every week for a year, the administrative law judge will be able to deduce that they do, in fact, have a severe medical condition and medical care may interfere with their ability to work.
Now, how does the administrative law judge weigh evidence from reports (such as residual capacity forms) specifically developed to substantiate a claim? Unfortunately, the ALJ is likely to give them very little value, especially if the doctor provides reports of this nature frequently for the disability lawyer. This report, however, can be useful if they come from the treating doctor and they are in addition to other medical evidence and supporting documentation within the claimants medical files.
A medical opinion is the third type of medical evidence and is generally useful to the disability lawyer. The administrative law judge may consider the information relevant, especially if it is consistent with other evidence from their medical file but may disregard it if it is not supported by other evidence. Keep in mind it will also depend on who is giving the opinion. A distinguished cardiologists opinion about a heart condition will be given more weight than a primary care doctor.
Medical opinions may also be offered by other medical professionals who are not considered acceptable treating sources. For instance, chiropractors, nurses, physicians assistants or social workers may also be able to offer valuable information about the mental or physical condition of the claimant.
Why hire a disability lawyer?
One of the main reasons to hire a disability lawyer, especially if you are at the hearing level, is so they can review your medical evidence within your SSA disability file and determine if it is sufficient to prove that you are disabled with a severe condition that does not allow you to work for at least 12 continuous months. If they cannot do this, you will not be awarded SSI or SSDI benefits.
- Pseudotumor cerebri and SSA Disability Benefits (disabilitybenefitshome.com)
- How to Win a SSDI or SSI Case Fast (disabilitybenefitshome.com)
- SSI and SSDI Disability - Do I have to see a doctor? (disabilitybenefitshome.com)