The importance of going to the doctor in a disability claim

Often we speak with clients who are going through the process of filing a disability claim

Attorney Wade Coye

Wade Coye, Disability Attorney

who don’t understand the importance of seeking medical treatment. It can put people in a kind of “catch-22” situation where they are injured enough not to go to work, but don’t go to the doctor to document the extent of their injury, and then are denied disability based on the lack of documentation. So what’s to be done in this kind of situation?

When a person first applies for Social Security Disability they often will receive an initial letter from the Social Security Administration (SSA) requesting a consultative exam (CE). Sometimes this is because a person’s primary care physician has not provided the SSA with supporting documentation and medical records which has the information the SSA needs to make a determination on that person’s disability. And sometimes this is because a person does not have any health insurance, does not have a specific primary care physician, or has not visited a doctor to document their condition.

The letter you receive from the SSA may not state that you are able to receive the consultative exam from your primary care physician, so you might call the number of your case worker on the letter to confirm that this is allowed. If so, provide the case worker with the contact information for your physician so your case worker can send the necessary paperwork to your doctor. You will also want to confirm with your doctor’s office that they are willing and able to conduct the exam. Some doctors are reluctant due to the paperwork, or they may not have the equipment to properly conduct the exam.

One problem that many people encounter when going to a consultative exam conducted by a third party doctor who doesn’t know all the details of that person’s disability is that the exam is not as thorough or detailed as the full records of the physician seen on a regular basis. It can take time, multiple visits, and a thorough examination to evaluate and diagnose a person’s disability status. This can require multiple visits, various tests, and several treatment attempts. Going to a physician once may not enable that doctor to fully appreciate the extent of a person’s disability and the problems that it has posed over time.

While the initial consultative exam is vital to an SSD case, follow up medical treatment can be just as important in establishing an ongoing condition, or in providing evidence that various treatment options have not worked to alleviate the disability. It is essential that you continue to follow up with your medical provider during the course of your disability claim or appeal. Sometimes we hear from clients that they are unable to afford multiple trips to the doctor, and we can appreciate the difficulty of that kind of situation. We have a list of valuable low and no cost clinics and resources available to clients to aid them in finding a medical provider who will be able to help them document their ongoing condition during the course of their disability claim.

The important thing is that a disabled person has access to the proper medical treatment they require, while at the same time receive a fair assessment from disability to be provided compensation for the fact that they cannot earn their own wages. When you’re disabled and cannot work, many concerns may present themselves and you should be able to focus on the most important thing of all: your health.

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