Work-related injuries are unpredictable and can quickly create a wide variety of concerns. Thankfully, workers’ compensation benefits often help bridge the gap between injury and the return to work.
Unfortunately, regardless of the industry, workplace accidents or illnesses often result in lifelong disabling conditions that can prevent an employee from returning to work. If a medical condition or combination of injuries or illnesses, work related or not, prevents you from returning to work for 12 months in a row, or longer, Social Security Disability (SSD) benefits may become necessary.
Statistics suggest getting an SSD application approved is not easy. Approximately 10 million Americans receive disability benefits. Since 87% of recipients are disabled workers, the need for financial assistance is clear. The Social Security Administration struggles to keep up with the number of applications it receives.
More than 100,000 deaths and 50,000 bankruptcy filings shed light on catastrophic wait times for approval. Meanwhile, the claim denial rate continues to increase, but there are ways to increase your chances of receiving the benefits you need.
What should you know about medical evidence for disability claims?
To qualify for SSD benefits, you must submit medical documentation from your treating medical providers along with your application. Social Security will ask you to sign medical releases and will contact your physicians and request copies of your chart. Your medical evidence should include the history of your injury or illness, clinical and laboratory findings, as well as the diagnosis and treatment prescribed and your response to treatment. It is essential that you continue to see your physicians on a regular basis during the application process, and that you are compliant with the treatment recommendations of your medical provider.
Your medical provider’s reports about what activities you can still do regardless of your impairment(s), based on your history, laboratory and clinical findings, can weigh heavily on the decision about whether you are disabled according to the legal definition.
Before you see your medical provider, remember:
- Doctors often feel rushed to see their other patients. However, you have the right to receive a comprehensive treatment plan.
- Be bold and advocate for yourself. Explain, in detail, what your symptoms are, especially pain, and how they offset your ability to work, or prevent you from performing activities at home.
- Your physician will not determine your disability eligibility. Yet, their report can factor into the decision to award you benefits. Depending on your situation, ask your doctor about laboratory work or additional evaluations, such as MRI scans, that may document your condition.
Generally, Social Security considers your regular provider’s opinion more persuasive when blood draws and physical exams support findings consistent with your medical record.
Since the Social Security Administration has the legal responsibility to determine whether you are disabled or cannot work, the Agency cannot consider your physician’s opinion on these issues. However, Social Security will consider all the medical findings and evidence that supports your medical providers’ opinion when the decision is made on whether you meet the criteria to be found disabled. It may be necessary for the Agency to re-contact your medical providers for additional information if they do not have sufficient information to make a decision. You may also be scheduled to be evaluated by a Consultative Examining physician by Social Security.
There are strict rules concerning the filing an Appeal of a Denial or Unfavorable Determination. If, at any point, you disagree with the determination made about your entitlement to benefits, you would be wise to explore your options with a firm experienced in seeking favorable results from the Social Security Administration.