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2 min read

Medical Records and Your Social Security Claim

The ability to submit all your medical records is vital to your Social Security Claim. A lack of evidence proving your medical condition is one of the fastest ways for the Social Security Administration (SSA) to deny your claim for benefits. It is vital that you have every piece of evidence submitted to them for review. This blog addresses why it is so important to have your complete medical history documented and what to do if you are unable to access certain medical records.

How Do Medical Records Impact Your Application?

In general, it is your responsibility to prove to the SSA that you are disabled. This responsibility is satisfied primarily by providing evidence of your disability in the form of medical records. For purposes of the SSA, “evidence” is anything you submit that relates to your claim for benefits.

Although the SSA must make a reasonable effort to develop your complete medical history, they are permitted to issue a decision on your claim for benefits even when medical records are missing. This means you can, and likely will, lose your claim for benefits if the evidence you supply to the SSA is incomplete.

What Medical Records Should You Include?

You should provide the SSA any and all evidence of your complete medical history. Complete medical history means any records, reports, labs, progress notes, or similar documents that pertain to the ailments you have alleged in your application. These records should cover at least twelve months prior to the month of filing, the protective filing date, or the date last insured – whichever date is earliest. The documents you provide can be from a medical source (a licensed healthcare worker operating within the scope of practice permitted under State or Federal law), or they can be from a non-medical source (any source of evidence that is not from a medical source).

What Happens If You Cannot Obtain All Necessary Medical Records?

The SSA has an obligation to reasonably assist you when medical records aren’t easily obtainable. If you find yourself lacking access to your medical records, you must document this fact on SSA Form SSA-5002 and submit it to them.

Once you have notified the SSA that you cannot obtain certain records, the SSA may make an initial request for your medical records directly to the sources and entities you have provided them in your application. The SSA may also make one follow-up request if the initial request is not completed. This is the limited extent of help you will receive from the SSA if you are unable to obtain certain medical records, and a decision on your claim for benefits will be made without those medical records being taken into consideration. That’s why it is absolutely vital to your claim for benefits to have a complete, and well-documented, medical history.

Do You Need Legal Advice from an Experienced Social Security Attorney?

It can be a challenge to navigate the SSA rules and regulations, but you don’t have to go at it alone. When dealing with such circumstances, it is to your advantage to seek legal advice from a skilled social security attorney. With such an advocate in your corner, you will push toward a positive outcome for your legal case.

The Social Security Disability Attorneys at Whitcomb Selinsky Law PC, and its sister firm, the Rocky Mountain Disability Law Group, have demonstrated skill and experience in dealing with SSDI, SSI, and related matters. If you need legal advice, please do not hesitate to contact us for assistance. You can reach the attorneys at Whitcomb Selinsky, PC, or RMDLG by phone at (866) 433-4116, (303) 534-1958, or online by completing a simple form on our website.