To get benefits for Social Security disability, you need to have a qualifying disability. There are financial standards to meet – such as the inability to work to make enough money to support you – but there are also medical standards that need to be met to prove your condition. Your physician and potentially doctors from the Social Security Administration (SSA) will need to see medical evidence of these conditions, but what does that mean?
“Medical evidence” is simply any proof of your condition that your doctor (or another doctor) can collect. This usually comes in many forms and can include records of hospitalizations and treatment, information taken from an examination, evidence of your physical limitations, test results, diagnoses, and even the doctor’s general impression of you. This evidence is often necessary to prove you have a qualifying condition or to update the SSA and show them your disability is still ongoing.
For a free review of your case and help with your potential disability claim, call our Arkansas disability lawyers today at (479) 316-0438.
How is Medical Evidence Used in a Social Security Disability Claim?
Before the SSA can grant your application for disability benefits, they need proof that you are disabled. As mentioned, this means providing them with financial information to show how much you used to make and how much you make now that you have a disability, but it also means showing that you, in fact, do have a disabling condition.
The SSA has a list of disabilities, each of which has medical definitions that must be met to show that you have the condition. There is also a severity requirement, which is usually incorporated into that definition. While some conditions will have pretty obvious definitions – like Section 4.09’s listing for a heart transplant requiring that you had a heart transplant – others have more complex definitions – like Section 4.04’s listing for ischemic heart disease. To meet that definition, for example, you need evidence, including at least one of the following: documented testing results meeting certain criteria; at least three separate ischemic episodes that led to surgery or were inoperable; or a qualifying coronary artery disease diagnosis with additional evidence.
As you can see here, the definition of the condition is closely tied to the evidence you can provide to show that you have that disorder. If the SSA does not have enough evidence to prove your condition, then they might deny your claim, saying that they cannot confirm you are, in fact, disabled.
Gathering this evidence and satisfying the SSA’s inquiry into the severity of your condition will be one of the most important parts of your claim that our Arkansas disability lawyers can help you with. Making sure you have all of the evidence required from the start can help you avoid denials and delays in benefits.
What Kinds of Medical Evidence Are Used for Disability Applications?
The actual evidence you provide can vary in form and format, but all of the following will usually play a part in determining whether you meet certain criteria for conditions:
Evidence of Hospitalizations or Procedures
The fact that you had a certain procedure or needed hospitalization for a certain condition will be good evidence that you have that condition. For example, as referenced above, you can prove you have ischemic heart disease by showing that you needed surgery at least three times for the condition. Similarly, the listing under Section 7.05 for sickle cell disease requires at least three hospitalizations in a year, lasting at least two days each time.
Medical Records
While some of the information about hospitalizations and procedures will be contained in your medical records, some facts and information just merely need to be “documented” for it to help you qualify with a condition. Some of the entries on the listing of disabilities require “documented” measurements, phenomena, test results, conditions, etc. If the doctors who treated you at the hospital or your primary care physician took good notes, their documentation of what you’ve been through can provide excellent evidence to help prove your condition.
For example, Section 4.02’s listing for chronic heart failure requires “[m]edically documented presence of” various cardiac events. Often, this kind of documentation means you will need records including actual test results, EKG results, or something of the sort.
Test Results
As mentioned, some medical evidence needs to be hard evidence, proven by test results. An EKG that recorded a cardiac event, blood test results showing particular levels, and even chromosomal testing (in the case of Down syndrome under Section 10.06) are all required by various medical definitions. Knowing what tests you need to prove your disability often requires guidance from your physician and your lawyer.
Experiences
Some elements of a particular diagnosis are merely observable things that you and your doctor can testify happened. For example, there is no blood test or EKG that can prove you have depression, but Section 12.04’s listing for depression looks for the presence of symptoms, like “[d]epressed mood” and “[d]ecreased energy” to prove your condition. If you have observed enough of these things – and your psychiatrist agrees that they’ve observed it, too – then you could qualify for a condition like this.
Limitations
Sometimes you and your doctor are required to fill out what’s known as a Function Report. These reports look into what limitations you have, how your disability affects your “activities of daily living,” and the various ways in which your condition is literally “disabling.” This report looks at what you can do on your own, what you can do for others, and what you need help with. For example, it asks about how your condition hurts your ability to dress yourself, bathe, and feed yourself. Even things like your ability to drive, manage money, and participate in hobbies you enjoy are all considered. Proof of limitations is required in certain medical definitions, but it also goes generally to the question of whether your condition is severe enough to keep you from working – which is necessary to qualify for benefits.
Call Our Disability Lawyers in Arkansas Today
For help with a disability application or getting denials and terminations overturned, call (479) 316-0438 to speak with our Arkansas disability lawyers today.