The Importance of Medical Records in Your Disability Benefit Application Case

Submitted by rsg on

If you have a disability which prevents you from working or your disability has deteriorated and you anticipate not being able to work for at least the next 12 months, you may consider applying for a disability benefit. Applications must be accompanied by medical records which establish the severity of the disability, its onset, development and treatment received.

The records must show that your disability matches the Social Security Administration’s (SSA’s) criteria for approval for a disability benefit. This article is intended to help applicants understand the importance of submitting these medical records.

Importance of Submitting Medical Records

Your Doctor and Treatment

One important aspect of a disability benefit claim is that the treating specialists who you have been seeing relate to the disability type you intend claiming a benefit for. For example, if you have a neurological disability, you should have disability medical records obtained from a neurologist; if you are suffering from some form of cancer, that you have been receiving treatment and ongoing monitoring of you condition by an oncologist.

Submit All Medical Records

All medical evidence in the form of disability medical records for your disability benefit case should be submitted well in advance of the deadline given by the SSA. This should be a minimum of 1 week before the deadline date.

The Cost of Getting Medical Records

Because medical records are a vital necessity for a disability benefit claim, you will need to obtain as many records as possible in advance of submitting your claim. The best way to keep a copy of all relevant medical evidence is to accumulate records sequentially as they are released. This takes a bit of foresight of course and you not everyone realizes that sometime down the track that they might need the documents, test records and other information that can help them obtain a benefit. Even working out exactly which documents should be obtained can be tricky as you are unlikely to be told specifically what records are being kept as your treatment and condition

Fortunately, medical records cannot be concealed from you and you have the right to obtain doctor’s records, specialists’ reports and the results of all tests, x-rays, scans etc. as well as evidence of how much it has cost you.

What does vary from state to state is the cost of obtaining these records after they have been issued. Many states impose a cap on the cost of obtaining records from providers or in some cases having a waiver on the cost. This is normally restricted to supplying records to you as the patient who is applying for a SSDI or SSI disability benefit.

You will need to find out from your state government health authority what the arrangements are for paying for past medical records. You will probably have to pay a minimum rate for things like copies of reports, as well as copies of test results and x-rays. These rates include the cost of copying, printing and mailing or emailing documents to you, although in most states providers are not allowed to charge for the time taken to actually locate the records, which can be considerable.

Here are a few examples of the cost of obtaining medical records.

  • Pennsylvania caps the maximum charge for supplying copies of documents at $1.60 per page for the first 20 pages, but this drops to a maximum of $0.41 for anything over 60 pages. Microfilm copies are charged at $2.73 each. Pennsylvania providers cannot charge for the time taken to locate documents as long as the documents are for your own disability treatment.
  • Georgia waives the cost of obtaining personal medical records as long as they are used to support a disability benefit application. If the records are obtained on your behalf, e.g. by an attorney, then the rates established by the Georgia Department of Community Health apply, e.g. paper document copies are charged at $0.97 per page for the first 20 pages, dropping to $0.66 per page for any more than100 pages.

As has already been mentioned, the way to avoid the cost of retrieving medical records needed to support your claim is to ask for copies of all records as they are produced. However, this does involve considerable foresight! If you are unfortunate enough to live in a state where the cost of retrieving medical records is more onerous and you cannot afford it, you may be able to apply to your state health authority for a personal waiver.

The Importance of Medical Records in Your Disability Benefit Application Case

Getting Help with Your Medical Records

When applying for a disability benefit from the SSA, you may understand by now that medical records are important but may be unsure exactly what medical evidence is needed to support your claim. Each type of disability is different and has different criteria that must be matched if a benefit application is going to be approved.

You may also be unsure how to obtain the medical records you need. This is where a disability attorney can be of great help. You should talk to a disability attorney before submitting a claim as they may have experience of dealing with the SSA and how the benefit application process works. Your attorney may be able to interpret the Blue Book criteria and based on their experience of previous benefit claims may be able to help you obtain the medical records you need to convince the SSA that your claim is justified.

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