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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.