CVC Case Manager L. Dani McGaha is a trained Social Security Administration disability advocate. She offers her tips for gathering medical records for disability applications.
Submitting medical records with your Social Security disability application can help expedite the process and ensure all of your records are received. So, consider gathering your medical records as a first step in the application process.
First, let’s examine why they’re important, then I’ll answer some common questions about how to gather and submit your medical records to Social Security.
Why are medical records important to disability applications?
The Social Security Administration (SSA) uses medical records as evidence to support your case. SSA evaluates your condition(s) using medical criteria known as the “Listing of Impairments.” The Listing of Impairments describes medical conditions, their severity, and the evidence required to determine if an individual should be found disabled. Law requires SSA to request supporting medical evidence to properly analyze a disability application, which can slow the process and extend the life of an application.
SSA will only follow up with medical providers or facilities a certain number of times before deeming they have “sufficient evidence” to move forward with a decision in your case. So, a decision could be made on your case even if all of the requested medical records have not been received. If SSA does not receive your medical records within a set period of them, they will make a decision in your case, which could result in a denial.
Luckily, you can help move this process along. Read on to find out how.
Before I get started—what will this cost me?
Sometimes providers charge you for medical records. But, many states have special laws associated with the costs of medical records for disability claims that limit medical record fees or waive them completely.
To determine if your fees are correct, or whether you should be charged at all, follow this link to look up your state’s laws. Also speak with your doctor if you have concerns about medical record costs.
OK, I want to collect my medical records. Where do I start?
To begin the medical record collection process, first determine which providers or facilities you will request records from. A good place to start is the provider/facility that knows the most about your condition (ex: neurologist, pulmonologist, psychologist, primary care physician).
Next, determine how far back you would like to request records. At CVC, our general rule is to request records approximately six months prior to when your condition(s) started limiting you, or six months prior to when you started seeing a specific provider.
We recommend requesting records that far back to ensure you obtain all that are available. For example, if you believe you first began seeing your provider in June 2017, you would request from January 2017 to present.
I’ve made my list of providers and dates. Now how do I contact them?
Once you determine the providers or facilities you would like to request your records from and how far back to request, you can submit the request to obtain records. You have a few options:
If you have an online patient portal account, like MyChart®, most times you are able to download and save your medical records from there. Some portals also allow you to submit your request for medical records directly through the portal.
If you do not have an online portal, contact the provider or facility to verify the best way to submit a medical record request to them (ex: fax, email, mail, etc.). Some providers will send you records with a verbal request. All you have to do is call and ask.
Others may want a written request or authorization form. If you submit a written request, include important information such as your name, date of birth, address, phone number, the name of the provider or facility you are requesting the records from, the dates you are requesting, and your signature. If an authorization form is required, ask them where to locate the form.
Note: Your provider may submit the request to a centralized medical records department to complete, so confirm if they process their own requests. If they do not, ask them for the contact information for the office that does. This is important to have when you are trying to follow up on your request.
I’ve submitted a request. Nothing has happened. Now what?
After one week if you have not received the records, follow up with the provider or facility or medical records department to confirm the request was received and obtain the processing time. If the request was not received, reconfirm where to submit the request and re-send it. If you learn a third-party (Ciox, IOD, MRO, etc.) processes the request, obtain the contact information and reach out to them to follow up.
Once you have followed up, we recommend waiting another one to two weeks to repeat the process. Continue to follow up until you have received the requested records. This process can take anywhere from a few days to a few months.
I’ve collected my records. Now how do I submit them to SSA?
Each level of the Social Security disability application process has different submission methods available:
- If you complete your initial or appeal application in person, provide your medical records to the representative that completed your interview.
- If you complete your initial application online, you will have the option to download a cover sheet once your application is submitted. Print the cover sheet then mail the cover sheet along with your medical records to your local Social Security office, or drop them off in person. If you drop off the records in person, make sure to get a signed and date-stamped receipt for your records. This helps ensure the records are properly attached to your case and avoid the likelihood they will be misplaced.
- If you complete your appeal online, for reconsideration or an administrative law judge (ALJ) hearing, you can attach your medical evidence directly to your appeal application.
We recommend that you keep copies of all of your records for yourself, in case they are lost or misplaced and you need to submit them again. If you are unsure whether something was previously included in your file, submit it again.
What if I have more records to submit once my application is pending?
If your application is already pending with Social Security and you have additional medical evidence to submit, then reach out to your local SSA field office. Let them know that you have additional medical evidence to submit and you need to know if your application is still in their office or if it has gone to Disability Determination Services (DDS). (DDS is the office that makes the medical decision.)
If your application is still with your local SSA field office: Confirm the best way to submit additional medical evidence. Remember to keep copies of the records for yourself.
If your case has been sent to DDS: You should receive notification in the mail with the contact information for the examiner working on your case. Reach out to the examiner to determine how to submit additional medical evidence to DDS.
If you have additional questions regarding this process or any other Social Security disability questions, please contact us.
For more on the disability application process, check out our other disability blogs.