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Q&A: The importance of medical records for a disability hearing

Although having disability qualifying conditions may make life miserable, the Social Security Administration application process mandates having an established assortment of disability supportive medical records. Attorney Harold W. Conick, who practices law across the Chicagoland area and across the U.S., said the most important thing is to have enough medical records to influence a judge regarding the seriousness of a medical condition.

“It’s important that they’re able to convince the judge with the records,” Conick said. “The medical records speak for themselves and are the key to proving that a claimant can’t work.”

Conick took time to explain the benefits of medical records to an SSA and Veterans’ disability case.

Q: How important are medical records for an SSA and VA disability case?

Conick: Medical records are the basis upon which judges in disability cases make their decision, so they’re extremely important. Not only are longitudinal records important, but current records as well. The more current the records, the more credible the claimant’s claim of disability is. The judges expect the records be current if you have an ongoing severe disability. If your disability is such that you are just receiving maintenance treatment, the judge will not expect to see extensive current treating records.

As an example, let’s say someone has a disease the doctor can’t do much for anymore. All they’re getting is medications and limited treatment. You’d just have maintenance records limited doctor office visits and prescription records. For someone trying to treat orthopedic or other serious problems like MS, cancer, diabetes, or mental illness the judge would expect to see significant, ongoing records to believe the person would not be able to work. If someone is not going to the doctor very much, but claims they have disabling symptoms, it’s not believable.

Q: Is there anything that typically goes wrong that may bring about a denial?

Conick: If the claimant doesn’t make an effort to cooperate with the securing of their medical records, in can influence the outcome. It could be something as simple as not telling me all the places they’ve been treated. It’s very important I know their complete medical history with doctors, hospitals, and therapy including all the medications they’re taking. This way, we can determine if we have all the medical records needed to support their case.

Q: Does the SSA and VA have their own doctors look at the records or applicants?

Conick: If you don’t get your medical records to the SSA or VA, it slows down the processing of the claim. Perhaps there are missing records for the past several months prior to a hearing; the judge may still feel that’s important because [the SSA’s] expert may have wanted to look at those records due to the claim of ongoing disability. The expert won’t be able to give an opinion to the judge unless there are current records to review.… They don’t always have in person exams. Experts will generally just be looking through medical records and based on what they have to review, if they don’t see enough to support your allegations, their opinion will not be supportive of a claim of disability.

Q: What does someone do if they have no insurance or other resources to see a doctor?

Conick: That’s a problem, because the system is not sympathetic to people who don’t have insurance or resources and can’t be treated. If you can’t produce the medical evidence, even though you have dire problems, it’s not going to help your ability to get Social Security or VA benefits. You can actually be denied because you can’t get treatment and thus treatment records; of course Veterans can seek treatment at the VA Medical Center. They’re not going to go out of their way to get you treatment to prove your case. You have to do that on your own. That is why it’s extremely important to seek out all medical resources available to obtain supportive medical evidence of conditions that prevent a claimant from working.

Solely trusting SSA online advice could be dangerous

Although there is some good information on Social Security Administration disability on their website, PBS blogger Larry Kotlikoff made a good point on a recent blog post that it may be a bad idea to trust everything that is said to be the full-disclosure truth.

“I don’t believe they are intentionally trying to trap people,” he said. “But I believe their ‘advice’ traps people into making the wrong decisions.”

The example he gives is a spouse benefit from the SSA. One sentence on the website says “this reduction factor is applied to the base spousal benefit, which is 50 percent of the worker’s primary insurance amount,” which is completely wrong, according to Kotlikoff. It applies to the excess spousal benefit he said, which is the base benefit minuses the spouses insurance amount.

This point should not be taken lightly. As well as some at-home research can go for someone applying for SSA disability benefits occasionally, it will help to have a legal representative to assist on filing paperwork, obtaining medical records and generally give good advice to the client.

While the employees of the SSA who prepare articles and brochures intended to advise the general public about disability and retirement benefits mean well, claimants should take such advice with a grain of salt and seek the professional services of their own counsel. This will help advise them about the law and regulations applicable to their situation.

The Law Offices of Harold W. Conick & Associates are available to advise clients concerning the Social Security regulations and the impact on a client’s particular situation. This will help the client achieve maximum benefits from the Social Security system.

Veterans can get up to $3,100 per months in disability benefits

Getting veterans benefits from the U.S. Department of Veterans Affairs shouldn’t be hard, but veterans will often face long waits due to a backlog. This is especially true for those who do not have a representative, as they may not know the ins and outs of VA as well. The Law Offices of Harold W. Conick and Associates knows what it takes to get these veterans benefits, which can be up to $3,100 for certain veterans.

While benefits may be as low as a couple of hundred dollars, those who fully qualify and have two parents could get up to $3,100 per month, according to VA. Those with two parents and a child have the potential to get even more than this from benefits. The amount each individual veteran will attain will depend largely on their situations and the injuries or illnesses they suffer from.

Veterans who have a more developed claim right away, which could be put together with the help of an attorney or representative, may be able to attain their benefits more quickly. The Fully Developed Claim Program is being run by VA to help process claims more quickly, a measure that was put in place to help reduce some of the backlog which exists. Veterans who need their benefits more quickly should look to get their medical records and claim together more quickly with this provision.

The Law Offices of Harold W. Conick, & Associates are available to represent veterans who are dissatisfied with a rating decision and other denial of benefits and wish to appeal such decision further in order to obtain their benefits.

Social security disability benefits are for more than the elderly

Although many people may think of Social Security Administration benefits as being only for the elderly, the recent “Fast Facts & Figures” notes that those with other disability qualifying conditions can be approved as well. Mark Miller wrote on Forbes that there are three main programs: Retirement, disability insurance and supplemental security income, which helps support those with low-income. Disability benefit recipients are the average age of 53.2 years old, down from 57.2 years in 1960.

Lisa Ekman, director of federal policy for Health & Disability Advocates, a non-profit advocacy group, said the growing demographic of those receiving disability benefits are those 48 to 67 years old. A big reason for the larger age may be the growing number of those supported by these disabilities, with 9 million disabled workers being paid this year, up from 5.9 million just 10 years ago. Social Security’s chief actuary Stephen Goss told Miller that despite worries that the SSA will run out of reserves, he believes there will be action by Congress taken.

“We’ll have 11.5 million people getting disability benefits in 2016, and they will be facing a benefit cut in an election year,” he told Reuters. “Can you imagine any Congress facing the music on that?”

The Social Security disability program is paid for from payroll taxes as well as from general tax revenues. The program is designed to replace income for those individuals who can no longer work. Claimants who, due to severe medical conditions, believe they can no longer work, should apply for benefits without hesitation. The Law Offices of Harold W. Conick & Associates are available to provide advocacy to those seeking disability benefits.

Political pressure may lead judges to deny claims; don’t give up

Even if someone has extremely damaging disability qualifying conditions, that does not guarantee approval of Social Security Administration benefits. There is growing political pressure in many circles on SSA judges to not approve benefits due to a belief that the system is failing, but claimants cannot let this get them down if they are in need of benefits. Freida Thomas, a Yahoo contributor, wrote that even after denial, people should not give up on on applying again.

“Remember that being approved for SSDI is a complicated process with several levels of reviews and requirements,” she wrote. “It takes time to determine if an applicant is truly qualified to be approved.”

Other things to consider:

  • Applicants cannot miss the appeal deadline of 60 days and should certainly appeal as quickly as possible
  • There needs to be a large amount of supporting medical evidence for a case to be approved
  • Claimants should seek the help of an attorney to be sure they are re-applying in a way that makes sense
  • Copies of all applications and forms must be kept

The SSA said nearly 11 million disabled workers receive benefits, up 7.6 million from a decade ago. Even if denied, there is still a chance for approval, it may just take some fighting.

The Law Offices of Harold W. Conick & Associates have successfully represented thousands of disabled clients over the past 30 years. It is extremely important for claimants not to become discouraged in the pursuit of their disability claim.