Medical Records and Supportive Evidence

medical records in a room

Medical records are crucial in a disability determination. At the initial application stage, Social Security will obtain medical records from each of the applicant’s providers during the relevant time period of alleged disability.

Once the application is filed, Social Security will typically send a letter requesting pertinent medical records along with medical release forms or authorizations signed by the applicant in compliance with HIPPA laws. Unfortunately, much can go wrong from this step of the initial application process through the decision by a Disability Determination Services (DDS) representative which typically occurs two to four months later. For example, the claimant may overlook one or more of their medical providers in their initial application, or fail to provide relevant updates (e.g. new physician, x-ray, hospital visit, etc.) to their DDS representative so that it may be requested and made part of the file.

Further, follow-up phone calls are typically required to ensure the record request was received, processed, and sent in to DDS for consideration. Oftentimes, the requests may be faxed back to DDS and, like many other electronic forms of communication, can encounter their own set of problems – they can fail to send, come through illegible or incomplete, or get filed incorrectly to name a few. The role of an attorney who specializes in Social Security benefits is to ensure that the client’s records are requested, received, submitted, and filed appropriately. Further, an attorney can draft Residual Functional Capacity (RFC) Questionnaires for the applicant’s medical providers to complete which can serve as additional evidence for the case. In fact, a RFC Questionnaire completed by one of the applicant’s treating physicians can actually assist DDS workers in understanding an applicant’s work-related limitations, and can even help lead to a quicker disability decision.

Social Security evaluates RFC Questionnaire and other forms of “opinion evidence” under CFR S 404.1527. In evaluating the weight of the medical evidence, the following factors are considered: examining relationship; treating relationship; supportability; consistency; specialization; and other factors, such as familiarity of the disability rules. Our attorneys at Disability Attorneys of Michigan understand these rules and can help individuals navigate from the application process through appeals to the District Court level.

I will never forget you and the hard work you did to secure my Social Security Disability benefits. Thank you!

- Christine C.