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SSA Disability - Does the SSA provide medical care?

There are thousands of Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) applicants who have a disability and who are unemployed and do not have medical insurance to pay for medical care.

One of the most common questions on our forum is, “Will the Social Security Administration provide medical care for me?” This question is asked in a variety of different ways so it is not always clear if the claimant is asking if they will get medical insurance after they are approved for SSDI or SSI or if the SSA will provide medical care for the applicant during the application process so they can get the medical care they need to diagnose their condition. In this blog we will address both issues.

Does the SSA help me get a diagnosis for my condition?

Ideally, prior to applying for SSDI or SSI benefits you will have already seen a qualified medical source (licensed medical doctor, psychologists, optometrists, podiatrists, speech-language pathologists, etc.) for medical treatment. If you have not seen the proper medical doctor and you lack sufficient medical evidence to prove you are disabled and unable to perform substantial gainful activity, the SSA may choose to send you to a consultative examiner for a medical review.

The consultative examiner will provide a diagnosis and information to the SSA which may be sufficient to win your SSDI or SSI disability case, but they do not provide medical treatment.  In theory it is possible that a C.E. could evaluate your conditions and provide sufficient evidence to the SSA that you are disabled and unable to work, but unfortunately, most of the claimants we hear from are complaining about the brevity of the exam and are denied benefits.

The consultative examination should not be considered “medical care.” They do not provide ongoing treatment for medical conditions, and although they provide information to the SSA about your diagnosis and limitations to work, the bottom line is you should not rely on their evaluation to ensure you win SSDI or SSI benefits.

Does the SSA provide medical care if I am approved for SSI or SSDI?

If you are awarded Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) you will get medical insurance. SSDI provides Medicare to applicants 24 months from the date of their disability. SSI claimants, in most states, will get Medicaid at the time of their approval (some states require the applicant to apply for Medicaid separately while other states do not automatically award Medicaid even for SSI recipients).

So while the SSA does not specifically manage your medical care or send you to doctors, if you are approved for SSDI or SSI benefits you should have a government medical insurance plan that may allow you to get affordable medical care for your health conditions. In fact, for many disabled applicants the option of affordable medical care may be worth more to them than the monthly cash assistance payments.

The Bottom Line

Because the SSA makes their disability decision based almost exclusively on your medical records it is imperative that you get proper medical treatment for your condition. As mentioned above, you may be sent to a consultative examiner but this medical evaluation is seldom helpful for most claimant’s SSDI and SSI cases.
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