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Medical Evidence for Disability: What Do You Need to Know

22 Jun
Posted at 14:42h in Disability by

The goal of an SSA analyst is to determine if you fall under their definition of disability so that you can claim long-term disability benefits. As a claimant, you are responsible for providing medical evidence of your impairments and their severity. While SSA can gather the evidence based on your list of resources, having proof ready makes processing your benefits faster.

Medical evidence turns the tide toward approval of long-term disability claims. Therefore, we discuss the scenarios of submitting medical evidence and how to document your disability case with suitable types of evidence comprehensively. In this manner, you have a higher chance of getting disability benefits. 

Submitting Medical Evidence Scenarios

The SSA analyst will need medical evidence such as copies of your medical records, health worker reports, and recent test results. However, there are some misconceptions people may have that they unintentionally delay filing their claims. Here are some scenarios we hope to clear up:

Scenario 1: You have your copies of medical evidence

Submit them immediately so the SSA analyst won’t have to call your medical source(s), such as hospitals, for them. When you have it ready, it makes filing your claims faster.

Scenario 2: You have incomplete copies of medical evidence

Submit the ones you have immediately. SSA will ask for your medical source(s) to send your evidence to SSA. Or you can apply and gather evidence after to make the process faster. If you apply early, you may retain your disability benefits.

Scenario 3: The obtained evidence from you and your medical source(s) is insufficient 

The SSA analyst will ask you to undergo a Consultative Examination (CE) paid from their pocket. However, SSA may prefer an independent medical source than your hospital or clinic to conduct the CE because of the following reasons:

  • Your medical source(s) isn’t qualified by SSA’s regulations
  • Your medical source(s) don’t perform the examination
  • Your medical source(s) don’t have the proper equipment
  • Presence of conflicting or inconsistent data in your medical records
  • You prefer another source for a good reason

The Three Keys for a Strong Medical Evidence

Ideally, CE is a convenient way for claimants to get a complete and detailed medical record sufficient for SSA. But to save time and energy, you can build robust medical evidence to make your process faster without requiring CE or making several trips to the SSA.

Because the SSA analyst needs to determine your disability, the evidence rule states that admissible evidence must have the following:

  1. Severity of impairment(s),
  2. Duration of the impairment(s), and 
  3. Limited functions that the impairments cause (walking, lifting, going to the bathroom, etc.)

This information can be found in a patient’s medical record. However, suppose the data still needs to be completed. In that case, we can use SSA CE’s objective and subjective evidence requirements to show the severity and duration of impairment(s) and how it limits the claimant. 

How to Strengthen a Disability Case with Objective Evidence

Objective evidence is measurable or clear signs of abnormalities that cannot be faked or exaggerated. It can include laboratory results or diagnostic imaging. Objective evidence per the evidence rule comprises:

  • The patient’s chief complaint(s),
  • A detailed patient history of chief complaint(s) from a specialized examination,
  • List of “positive” and “negative” findings based on the history, examination, and testing related to the chief complaint(s) and other abnormal occurrences of lack of it,
  • Required laboratory and medical test results based on impairments,
  • Diagnosis and prognosis of the claimant based on their impairment(s), and
  • Assessment of an adult claimant’s Activities in Daily Living (ADL), including the ability to work, or
  • Assessment of a child claimant’s Activities on Daily Living (ADLs), including the ability to function and compared to children their age who do not have the claimant’s impairment(s)

Therefore, to substantiate your disability case with objective evidence, you will need the following:

  • Get all recommended diagnostic and objective testing.
  • Have additional evaluations to provide more accurate proof of your symptoms and limitations.
  • Create a detailed list of your medical appointments. 

How to Strengthen a Disability Case with Subjective Evidence

Subjective evidence is documented symptoms experienced by the claimant. The more consistent the subjective evidence is, the stronger it is as evidence. Here is the subjective evidence on the SSA CE requirements:

  • Description of claimant’s daily activities after the impairment(s)
  • Duration, intensity, location, and frequency of pain and other symptoms
  • Factors that trigger or aggravate symptoms
  • Medications: type, dosage, side effects, effectiveness
  • Treatment for pain and other symptoms aside from medications, such as physical therapy
  • Other measures for pain and other symptoms aside from medications, such as adaptation tools
  • Other factors that affect the claimant’s functional limitations

Therefore, to substantiate your disability case with objective evidence, we recommend the following:

  • Reporting all your symptoms to your doctors at every appointment for proper documentation
  • Following your doctors’ prescriptions and recommended treatments as non-compliance can be seen as disinterest in getting better
  • Keep a detailed record of your medications and their side effects to give SSA an understanding of how your meds can impact your ADLs and ability to work

How to Strengthen a Disability Case with Medical Expert Opinion

Your healthcare provider’s assessment of your condition can provide insightful information on how it impacts your life. 

  • The consultant’s signed evaluation of the claimant’s chief complaint(s) on the patient history, examination, and findings

Aside from getting narrative letters of your condition from your healthcare provider, we also recommend the following:

  • Getting treated frequently helps your doctor be familiar with your conditions and their consistency within your medical record.

How Marken Law Can Help You

Consistency among the objective and subjective evidence and medical consultation strengthens your disability case. At Marken Law, we review your disability case for inconsistencies and missing requirements. Then we assist in adding more supportive medical opinions to create your extensive medical evidence. 

Depending on the case, here are our methods to make explicit disability claims for you:

  • Interview your doctor through a questionnaire. The questionnaire we provide is relevant to your specific conditions. The results are drafted so the SSA analyst understands how your condition limits your daily activities.
  • Collect clarifying answers from your healthcare providers on conflicting data, unexplained findings, and complicated conditions so the SSA analyst does not have to.
  • Get medical opinions from our medical network. As lawyers licensed in Washington, Idaho, Oregon, and California, our medical connections objectively review your medical evidence, and we record their evaluations. Their evaluations can also support the expert opinions of your healthcare providers.

Glaring medical evidence cannot be ignored. To get approval for your disability claims fast, you’ll need to get everything right. We can help by starting with a free consultation.