Understand the Role of Medical Evidence

Medical evidence is crucial because it helps the SSA determine the severity of your condition and whether it prevents you from performing substantial gainful activity (SGA). To qualify for Social Security Disability benefits, you must prove that:

• Your medical condition is severe enough to limit your ability to work.
• The condition has lasted, or is expected to last, at least 12 months, or is expected to result in death.

The SSA evaluates the evidence based on their Listing of Impairments, which outlines specific criteria for various medical conditions. Your medical records will be compared to these listings to see if your condition meets or equals the severity levels required for disability benefits.

Gather All Relevant Medical Records

The first step in submitting medical evidence is gathering all relevant records related to your condition. This includes:

• Doctor’s Reports: Make sure you provide reports from your primary care physician and any specialists who have treated your condition. These reports should detail your diagnosis, treatment, and how your condition affects your ability to work and carry out daily activities.
• Hospital Records: If you’ve been hospitalized or had surgeries related to your disability, submit all hospital records, including discharge summaries, surgical reports, and follow-up care notes.
• Lab Results and Imaging Reports: Any lab work, X-rays, MRIs, CT scans, or other diagnostic imaging reports that help prove your condition should be included.
• Prescriptions and Treatment Plans: Provide records of any medications you are taking, along with any physical therapy or other treatments prescribed to you.
• Doctor’s Opinion: A letter or statement from your treating physician describing how your disability affects your ability to work can be very helpful. This opinion should include the medical facts and how your condition limits your functional capacity.
• Mental Health Records: If your disability includes mental health conditions (e.g., depression, anxiety, or PTSD), include psychiatric evaluations, therapy notes, and any relevant mental health treatment records.

Submit Medical Evidence with Your Application

When applying for Social Security Disability benefits, the medical evidence you’ve gathered should be submitted with your initial application. The application is usually done online through the SSA portal at www.ssa.gov, but you can also apply in person at your local SSA office or by phone.

Here’s how to submit your medical evidence:

• Online Application: If you’re applying online, you will have the option to upload electronic copies of your medical records directly through the SSA’s online application portal. Be sure to follow the instructions carefully to upload documents.
• In-Person or Phone Application: If you apply in person or over the phone, bring physical copies of your medical records to the SSA office or have them sent directly to the SSA.
• Ensure Accuracy and Completeness: Make sure that all the medical evidence you submit is accurate, up-to-date, and complete. Missing or incomplete records can delay your claim or lead to a denial.

Keep a Record of Everything You Submit

It’s crucial to keep copies of all the medical evidence you submit, as well as any correspondence with the SSA. This includes:

• Copies of your medical records and any additional documents you submit.
• Confirmation that the SSA has received your medical evidence (for example, if you mail documents, make sure you use a trackable service).
• Notes of any calls or visits to the SSA office, including the names of the representatives you spoke with and the details of your conversation.

Allow the SSA to Request Additional Medical Evidence

Once you submit your initial application, the SSA may request additional medical records or information from your healthcare providers. They may contact your doctor or specialist directly to obtain updated records. If the SSA requests additional evidence, make sure to provide it as quickly as possible to avoid delays in processing your claim.

Using Your Treating Doctor’s Opinion to Strengthen Your Case

One of the most important pieces of medical evidence you can provide is a statement from your treating physician. The SSA tends to give more weight to opinions from doctors who have been treating you regularly, rather than a one-time evaluation. Your treating physician can provide insight into:

• How your disability affects your ability to perform daily tasks.
• Whether your condition has worsened or is expected to improve.
• How your medical treatments have impacted your functionality.
• Any restrictions or limitations you have due to your condition.

If your doctor is willing to complete a Medical Source Statement or Residual Functional Capacity (RFC) form, this can be a helpful addition to your medical evidence. These forms specifically address the limitations caused by your disability and how it affects your ability to perform work-related tasks.

Follow Up with the SSA

After you’ve submitted your medical evidence, it’s important to follow up with the SSA to ensure that they have received everything necessary for your claim. You can check the status of your application online by creating an SSA Online Account or by calling the SSA at 1-800-772-1213. If they request additional evidence or information, respond promptly.

Appeal If Your Claim Is Denied

If your initial application is denied, it’s important to review the reason for the denial carefully. Often, claims are denied due to insufficient medical evidence. If this is the case, you may need to submit additional medical records or seek legal help to file an appeal. The appeal process often involves:

• Requesting Reconsideration: The SSA reviews your claim again with any additional evidence you provide.
• Requesting a Hearing: If reconsideration is denied, you can request a hearing with an Administrative Law Judge (ALJ), where you can present additional evidence and argue your case.