Evidentiary Requirements for Social Security Disability Claims
Yesterday, I had a successful Administrative Law Judge Hearing with claimant receiving a fully favorable determination from the Social Security Court (Office of Hearing Operations). The claimant suffered from a severe case of schizophrenia. Many people do not know that a case may take up to 24 months before it is in front of a judge from the time it is filed. Not all case need to appear in front of the judge and can be completed sooner.
In that time frame, I often get to know the claimant and at time the family of the claimant. It is always a fantastic feeling being able to help those who are already suffering with help they need from the government.
Yesterday was no exception. I am happy to get them over this hurdle and on their way. With a favorable finding, the claimant will be eligible for multiple programs that will help him eventually stabilize and maybe even find work.
However, like most hearings, the decision wasn’t easy for the judge. As I stated in the 5 Steps to Determining Eligibility and Residual Functional Capacity, claimants need to have a diagnosis, that diagnosis needs to be severe, and there needs to be documentation providing SSA the claimants RFC.
“Each person who files a disability claim is responsible for providing medical evidence showing he or she has an impairment(s) and the severity of the impairment(s). However, the Social Security Administration (SSA), with the claimant’s permission, will help the claimant get medical evidence from his or her own medical sources who have evaluated, examined, or treated the claimant for his or her impairment(s). SSA also requests copies of medical evidence from hospitals, clinics, or other health facilities when appropriate.”
It is not always easy getting medical providers to determine RFC or document it for the purposes of a hearing. I typically will have claimants provide further documentation beyond just medical records for SSA to help determine RFC and the severity of the disability.
Other options include using a consultative exam. “If the evidence provided by the claimant's own medical sources is inadequate to determine if he or she is disabled, additional medical information may be sought by recontacting the medical source for additional information or clarification, or by arranging for a consultative examination (CE).” https://www.ssa.gov/disability/professionals/bluebook/evidentiary.htm
Documentation is key to helping your case with Social Security Administration. For more information or a free consultation, please contact Long & Vernon LLP. 619-485-2900
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