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What medical evidence is needed to process a SSDI claim?

In our last post, we discussed the definition of disability for purposes of awarding Social Security disability insurance. This week we will discuss the medical evidence that is necessary to make a determination as to whether one is considered disabled for the purposes of receiving benefits. While this post is not a substitute for the advice of a legal professional, it should provide more information regarding medical evidence and Social Security.

It is the responsibility of applicants in Pennsylvania to provide the Social Security Administration with medical evidence demonstrating both the existence and the severity of their illnesses, injuries or impairment. That being said, the SSA, per the consent of the applicant, may in some circumstances aid the applicant in obtaining the necessary medical reports.

Usually, medical evidence comes from the doctors, hospitals, therapists and other sources that have examined and treated the applicant with regards to their disability. Social Security regulations define what is to be considered an accepted medical source. Acceptable medical sources include licensed physicians, licensed optometrists, licensed psychologists, qualified speech-language pathologists and licensed podiatrists.

The regulations promulgated by the SSA emphasize evidence should be obtained from what are considered to be treating sources, because these sources may be best able to provide a detailed picture of the applicant's illness, injury or impairment, as compared to a one-time examination or brief emergency room visit. Gaining a report from a treating source can expedite the claims process by providing sufficient information without the need for further medical evidence. Reports should contain information pertaining to the applicant's medical history, lab results, clinical findings, diagnoses, treatment and a statement regarding the applicant's abilities.

In a future post we will discuss whether and when consultative exams are necessary. Until then those with questions about the medical evidence needed to complete their SSDI application may want to seek the advice of a legal professional.

Source: ssa.gov, "Disability Evaluation Under Social Security: Part II - Evidentiary Requirements," accessed Jan. 19, 2015

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