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Will rules involving Social Security Disability be tightening?

Written by Ankin Law Office

The Social Security Administration follows strict rules when evaluating whether a person meets the definition of “disabled” and qualifies for Social Security Disability benefits. As many Chicago residents know, this can make securing benefits challenging even for people with serious conditions. Proposed rule changes the SSA is currently considering could make obtaining benefits even more difficult for some disabled Americans.

Full disclosure

The new rules would explicitly require SSD applicants to supply all medical evidence pertaining to their cases, according to The Wall Street Journal. This includes evidence that could harm the applicant’s case. Congress has encouraged the SSA to consider these changes in the wake of a 2011 Wall Street Journal investigation. The investigation alleged some legal representatives withhold medical evidence if it could reduce a claimant’s likelihood of receiving disability benefits.

SSA claim examiners are responsible for collecting all evidence relevant to each claim. However, they may sometimes overlook or struggle to find necessary evidence. This may especially be true of administrative law judges, who hear claims that have been denied and appealed twice. According to The Wall Street Journal, these judges often decide several cases a day, so they may lack time to look for information to supplement the documentation applicants submit.

The new rules would require applicants, rather than legal representatives, to submit all relevant medical records. Professionals have previously debated whether representatives are ethically bound to submit full medical evidence or focus on winning their clients’ cases. The new rules avoid conflicts with attorney-client privilege by addressing applicants directly.

Supporting evidence

The SSA is accepting feedback on the proposal and may implement changes in the near future. However, even if the new rule is not adopted, people seeking Social Security Disability benefits are still expected to provide necessary medical evidence. In many cases, doing so also benefits applicants.

Medical evidence helps establish the duration, severity and prognosis of a disabling condition. This evidence helps prove an applicant meets the terms of a “Blue Book” impairment listing or cannot work gainfully because of the medical condition. Personally submitting medical information offers applicants benefits during the application process:

  • Applicants can be certain the SSA won’t miss important evidence.
  • Applicants can ensure the records the claim examiner reviews are accurate.
  • Applicants can document information that might not be clear during a consultative examination.
  • Applicants may receive a faster decision, since they eliminate delays in obtaining records.

Even if medical evidence contradicts or undermines an applicant’s claim, the applicant should submit it and prepare to explain the apparent discrepancy. Sometimes, applicants may clarify the issue with more detailed evidence. Applicants can also consider meeting with a legal representative who can provide advice on properly documenting and presenting the claim.

Categories: Social Security