Each year, millions of United States citizens apply for Social Security Disability benefits through the Social Security Administration. Some studies indicate that as many as 70 percent of all claims are denied, and a significant number are rejected because of missing or incomplete medical records.
Before you file a disability claim, you’ll need to attain your health records in order to successfully facilitate the process. When requesting your health records for your SSA Disability claim, the following steps can prove helpful:
6 Steps for Requesting Medical Records for Social Security Disability Benefits
- Make a List of All Doctors Who Have Treated Your Condition
- Talk to Your Primary Physician
- Submit Your Medical Records Request
- Consult a Knowledgeable Disability Attorney
- Provide Reasonable Time for Response
- Send Your Records and Your Application to the SSA
If you’re wondering how to get medical records for your social security disability case, keep reading. The information below can help you make good decisions about how and when you should begin the process of requesting your health records, along with how to get the help you need.
Why Your Medical Records are So Important
Your medical records are one of the most important factors the SSA considers when making determinations regarding disability claims. In many cases, the SSA will not approve a Social Security disability claim that lacks appropriate medical documentation. It’s important to provide everything you can, even notes from your doctor. Medical records take a wide variety of forms, including records of mental health, vital statistics, diagnosis information, reports of imaging studies like MRI, CT scans or X-rays, bloodwork panels and more.
Many times, your physician’s detailed notes and statements can make the difference between approval and rejection. His or her feedback can help the SSA understand how your disability impedes your abilities to perform full-time work activities. In fact, your physician’s statements often carry the most weight with the SSA; the prevailing philosophy is that a doctor you see regularly will understand your medical issues better than any other source. He or she should be able to effectively articulate exactly how your medical condition affects your everyday life and how it has specifically compromised your ability to earn a living.
Your copies of medical records should establish a full history of your claimed medical condition, and your current medical records may be even more important. They illustrate the full extent of your medical condition at the present moment and add to the history of how your condition has progressed.
Now let’s look more closely at the steps you’ll need to take to secure your medical records and complete your SSA Disability claim.
1. Make a List of All Doctors Who Have Treated Your Condition
This is an important first step toward making sure your critical medical records requests are comprehensive. You need to include input from every medical center and physician who has treated you throughout the duration of your condition – and especially those who have treated you since you stopped working. Document your physician’s office contact information from the very beginning, along with their approach to health information management. This will allow you to stay organized and focused, and able to track responses.
2. Talk to Your Primary Physician
One of the best steps you can take toward winning your claim is to consult with your primary health care provider before you start the process. He or she can offer tremendous insight into how your medical records would be interpreted, and knowing in advance that the records request is coming may help the practice team to respond more efficiently.
It’s a good idea to get your physician’s early assessment of whether you are too disabled to work and how your medical records will tell that story. This is a good chance to verify that the Social Security disability route is the best for your situation and is supported appropriately. An experienced disability attorney can also help you make this determination.
3. Submit Your Medical Records Request
Most of the time, you can obtain your medical records simply by requesting them from your physician’s office. Some offices will allow you to request electronic medical records, while others may insist on charging copying fees to give you physical documents.
You may be required to complete a medical records release form or health information form made available by the health care provider that formally documents your request. These authorization forms can typically be hand-delivered to the office administrator, or sent via fax, email or the U.S. Postal Service. Sometimes you can even request medical records online, for example, through a patient portal, where you can access the necessary authorization forms. Check with your health insurance company as well, as they may have a patient portal with organized medical records.
If an authorization form is not available, you can also write your own letter requesting your records. Your letter should include your name, social security number, date of birth, address, phone number, email address, a list of the specific records being requested, dates of service, and how you would like the records delivered. Make sure to sign your letter, and you also may want to include a copy of your driver’s license.
4. Consult a Knowledgeable Disability Attorney
Your physician’s office may quickly provide you with the appropriate patient records that are timely, accurate and sufficient for supporting your claim. Sometimes, however, physician offices, clinics or hospitals may be slow to respond. If your health care team fails to submit crucial documentation, your benefits claim could be delayed – or worse, denied due to insufficient support.
A disability attorney will act on your behalf to ensure that the SSA has what it needs to make an appropriate review of your claim. An experienced attorney who knows the ins and outs of the system, and understands how various federal agencies like Medicare interact with SSA, can ease the burden of this process.
5. Provide Reasonable Time for Response
The next step is a hard one – the waiting. Most states require that your records be released within 30 to 60 days, but the time does vary. If you’ve waited longer than 60 days, you can also reach out to your state’s Department of Health for support, especially if you’ve made several attempts with no success.
If you are working with a qualified disability attorney at this point, he or she can also work with physician offices, hospitals, etc., to ensure that comprehensive records are released in a timely manner.
6. Send Your Records and Your Application to the SSA
Once you have submitted your application and supporting medical documentation to the SSA, you should wait to receive a Notice of Hearing. During your hearing, following your medical records review, a judge will pose questions that seek to determine an objective ruling on whether your claim should be accepted. Following the hearing, you will receive the judge’s written decision by mail.
Why You Should Request Your Medical Records
Ultimately, the responsibility for getting your medical history into the hands of the SSA rests with you. The examiners will make every reasonable effort to gather the salient protected health records from your physician or hospital, but that doesn’t mean that every file needed will be shared. Often, medical centers and hospitals become overwhelmed with patient medical records requests, and while some are extremely efficient, others may take months before even considering a request. At that point, it’s still possible for important information to be inadvertently left out of your comprehensive medical history.
When you gather your health records yourself or have an experienced disability attorney request them on your half, you can review what they provide so that you know exactly what medical documentation is available and what, if any, information is missing. Sometimes a patient’s request for records is more powerful than a request from the SSA. You may even be able to speak directly with your physician about your patient care request, which can help ensure you receive complete, accurate records.
You may be able to speed up the consideration of your claim by supplying your medical records yourself. Many of the delays associated with claim consideration relate to the processing time for medical records. Before they are received, the SSA is unable to judge your claim.
It’s a good idea to have a disability attorney review your file or advise on how to request medical records. In fact, it is often in applicant’s best interests to work with a disability attorney throughout the entire SSA disability application process. Disability lawyers know from experience how best to present your application, along with what evidence is necessary to support your claim for benefits.
When to Request Your Medical Records
In general, it is a good idea to request copies of your archived medical records on a regular basis so that you can review them for accuracy. For your SSA Disability claim, it’s best to make your medical records request(s) as early as possible so that you allow plenty of time for follow-up and review before submitting your full application to SSA.
It’s important to note that a medical records department is typically required to keep archived medical records for at least six years. But medical laws vary by state, so make sure to check guidelines for your area as you determine the necessary time frame of your patient medical records.
What Happens if My Claim is Denied?
If the SSA approves your claim, you should begin seeing benefits within a few months. But – if you were unable to attain the most timely, accurate and sufficient medical records to support your claim, you may receive the news that your claim has been denied. Don’t lose heart – this isn’t the end of the process. The SSA also makes available a disability benefits appeal process that gives you another opportunity to effectively make your case. This is another important step in the process where it behooves you to work with an experienced disability attorney who can advocate on your behalf.
Filing a Social Security Disability Claim
The SSA claims process can be complicated, overwhelming and often difficult for those who are struggling with health issues. SSA claims are often won or lost based on the quality of their medical evidence. Your ability to provide accurate and timely documentation about your health may make the difference between your claim being approved and denied.
But it is possible, and even easy, to get the help you need – working with an experienced legal representative can help smooth the process and ensure that you have all appropriate medical evidence to support your claim. Because qualified disability attorneys work on cases like yours on a day-to-day basis, they are familiar with what the SSA needs and how to provide it – working with a disability lawyer can make your claim for disability benefits both successful and stress-free. For assistance with your Social Security disability claim, contact the experts at Acadia Law Group today.