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What if you apply for disability and your medical records are old?
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If you find that you will need to apply for Social Security disability due to a mental or physical impairment that prevents you from engaging in substantial gainful work activity and you have no current medical records, you should, ideally, try to get some kind of treatment for your disabling condition. Social Security considers any medical treatment records that are older than ninety days not to be current. What bearing does this have on a case? Social Security disability examiners cannot make a medical determination without current documentation.
What does the Social Security administration do if you cannot provide current records and documentation for your disabling condition, or conditions; in other words, all of your medical treatment information is old?
Social Security will still try to gather older information from your medical treatment sources in order to establish a longitudinal history of your physical and/or mental condition. The social security disability examiners who process claims prefer to have at least a twelve month history when rendering a disability determination, so older medical records can generally be useful.
Older records may also be needed to properly determine a claimant's EOD, or established date of onset, so that back benefits may be properly calculated and paid, particularly if retroactive benefits--benefits for a state of disability existing prior to the actual filing date of a title 2 social security disability application--are being sought.
For disability claimants who are without “current” medical treatment records, Social Security will typically schedule what is known as a CE, or consultative examination, to establish their current status with regard to their claim for disability. These examinations are conducted by independent medical physicians, psychologists, and psychiatrists to provide a "current snapshot" of a claimant's condition, which, in many cases may be all that is missing from the file being reviewed by a disability examiner.
Unfortunately, consultative examinations, by their very nature, are often unable to provide an accurate picture of how disabling a claimant's condition may be. The consultative examiners who perform examinations for social security will ordinarily have had no history of treating the claimant and will typically be unfamiliar with the claimant's past history of treatment.
Making matters worse, these examinations are often short and have a widely-commented reputation for not being particularly thorough. However, for claimants who have not been seen in the last ninety days by a medical physician or a mental health treatment specialist, a consultative examination may be the only way for social security to acquire some type of objective medical information in order to render a Social Security medical determination.
Will a consultative examination have a great bearing on the outcome of a disability case? In many instances their effect is negligible. However, in some cases the results of a mental or physical CE can determine whether or not a case is won or lost.
If you are required to attend a consultative examination, it is advisable to give an honest portrayal of your limitations. Many individuals push themselves at their consultative exams and actually appear to be better than they are while others give a less-than-best effort and are labeled as malingerers.
Practical advice for any claimant who has been scheduled to attend an appointment for a consultative exam is simply to give an honest report of one's condition to the examining specialist at the consultative examination.
Additional information on SSD and SSI may be found at Social Security Disability Secrets.
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