Penrose St Francis Hospital blocking faxed records request
Penrose St Francis Hospital, one of the two major hospitals in Colorado Springs, sent me the following canned response to a (faxed) request for records for one of my clients.
Please note that the fax number you are sending your request to is for physician use only.
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Medical records requests from law firms need to be mailed to our facility in order to be processed.
Penrose St Francis is refusing lawyers from faxing requests for medical records. Penrose St Francis has a fax number for requests. They even use an third party medical copying service for processing record requests (so, it is not like nurses have to take time out from helping patients …
How do I prove my disability case when I look fine?
This is one of the most difficult issues in a Social Security disability case. You might look “normal,” but you know that there is no way that you can work.
If you tell someone that you are applying for Social Security, they may raise their eyebrows in surprise, or even tell you, “you don’t look disabled.”
When you applied for Social Security, the technician may even have given you a hard time because you seemed fine.
15 pages decides your Social Security disability case?
San Francisco disability attorney Geri Kahn wrote about her experiences with providing records to Social Security:
Before filing a new initial claim I always order the records and then submit them directly to the Social Security field office immediately after I have filed the claim electronically. I recently was at an interview in one of the field offices in San Francisco and the claims representative told me that he could not accept the records I was submitting because he was only permitted to fax 15 pages to the state agency disability examiner.
Since you need to prove that you are unable to …
What is a rheumatologist?
The American College of Rheumatology has a great overview of what a rheumatologist is and when you should consider seeing one.
A rheumatologist is an internist or pediatrician who is qualified by additional training and experience in the diagnosis and treatment of arthritis and other diseases of the joints, muscles and bones. Many rheumatologists conduct research to determine the cause and better treatments for these disabling and sometimes fatal diseases.
What Do Rheumatologists Treat?
Rheumatologists treat arthritis, certain autoimmune diseases, musculoskeletal pain disorders and osteoporosis. There are more than 100 types of these diseases, including rheumatoid arthritis, osteoarthritis, gout, lupus, back pain, osteoporosis, fibromyalgia and tendonitis. Some of these are very serious diseases that can be difficult to diagnose and treat.
When Should You See a Rheumatologist?
If musculoskeletal pains are not severe or disabling and last just a few days, it makes sense to give the problem a reasonable chance to be resolved. But sometimes, pain in the joints, muscles or bones is severe or persists for more than a few days. At that point, you should see your physician.
Seeing a Rheumatologist in a Social Security case:
Seeing a specialist can often be critical in the Social Security case.
How to diagnose fibromyalgia
It can be very difficult to win Social Security disability benefits based on fibromyalgia. However, it can be done!
While Social Security no longer considers fibromyalgia as a “imaginary” condition, or a “junk” diagnosis, you still need to make sure the diagnosis of fibromyalgia is backed up by medical findings.
I have reviewed many medical records which mention fibromyalgia, but don’t say how the doctor made the diagnosis. There is no mention of physical examinations or findings. Social Security may throw out the diagnosis because of a lack of medical support.
Without a diagnosis, all you have are symptoms and Social Security cannot approve disability benefits on symptoms alone.
This can stop a case dead in its tracks!
So, what do you need to properly diagnosis fibromyalgia?
Should I see a specialist when applying for Social Security?
I am often asked whether seeing a specialist will help in a Social Security disability case.
Do I need to see a specialist? I have my own doctor. What else can a specialist tell me about my case? How can they help?
I have seen numerous cases where Social Security has downplayed the opinion of a treating physician because the doctor is not a specialist!
I have even seen some cases where the Judge rejected the primary care provider’s opinion at hearing because he thought the doctor was just “saying what the patient wanted the doctor to say.”
A lot of these problems can be eliminated with a specialist’s evaluation and medical opinion.
Does Social Security set a maximum fee for medical record charges?
The answer to this is “yes,” and “no.”
When Social Security requests medical records from a treatment provider (doctor, hospital, walk-in clinic, physical therapist, chiropractor, etc.), and they put a cap on how much they are going to pay for those records.
Unfortunately, they do not put any cap on how much the medical records provider can charge you if you request the same records. I have previously written about how much treatment providers can charge for medical records in the state of Colorado. Other states have similar laws in place setting the maximum for medical record charges. However, Social Security gets the best deal when it comes to requesting medical records.
You can use this to your advantage.
Another use for ALISON: has your doctor been suspended?
ALISON (Automated Licensure Information System Online), is the online licensing database for the state of Colorado. I previously wrote about how this site is a great resource for finding an address for your doctor.
This site also has another use. If your doctor has been suspended, this will show up ALISON.
Need help finding your doctor’s office in Colorado?
When you apply for Social Security benefits, you will need to provide the name and address of each doctor you have seen for the last several years.
You may have this information for your current doctors, but finding the addresses for your older doctors may be trickier.
How do I find your doctor’s address if she has moved her office?
You can check old business cards, appointment cards, medical records or invoices for this information. You can also check the yellow pages, or check Google.
If all this fails, there is still one more way to track down a doctor.
If you are in Colorado and you have internet access, try ALISON (The Automated Licensure Information System Online). This is the online licensing database for the state of Colorado. If the doctor is licensed in Colorado, you should be able to find the doctor and the his/her current business address.
Why doesn’t Social Security get a statement of my limitations from my doctor?
You already know how important it is to get a Medical Source Statement in your Social Security disability case.
The best source for this is your own doctor.
However, I typically see Social Security have one of their technicians or a Social Security doctor, who has never seen or examined you, determine your limitations.
When I discuss this with my clients, I am often asked why? Why does it seem like Social Security purposefully avoids getting this information from the best source, your own doctor?
My opinion is that Social Security wants to ensure an objective opinion and believes …
I don’t want to have surgery, can Social Security make me?
As a general rule, if you are applying for Social Security disability benefits or appealing a Social Security denial, Social Security can penalize you for noncompliance with your doctor’s instructions about your medical treatment or care. That means Social Security may deny your disability claim if you do not follow your doctor’s instructions.
However, there are exceptions!!! Social Security cannot just use the non-compliance rule whenever it wants to. See Social Security Ruling SSR 82-59.
First, the doctor actually has to prescribe the treatment. Not just merely discuss the option of treatment.
The treatment must also be clearly expected to restore functioning to the point that you are no longer disabled. That means, that the treatment is expected to allow you to go back to full-time work. If you would still be disabled in spite of the treatment, then non-compliance is not an issue.
The evidence shows that you have refused to follow the treatment.
Even if Social Security can meet these three burdens, there are reasonable excuses which will prevent Social Security from penalizing you for not following doctor’s instructions.
Social Security disability: what if your doctor does not believe in you?
Your doctor’s opinion of your disability is critical evidence in your Social Security disability case. If your doctor does not believe in you, you and your lawyer are facing an uphill battle.
Chances are, Social Security either sent you to one of their doctors for a consultative examination, or had your medical records reviewed by a Social Security doctor. If Social Security denied your claim, their doctors probably did not think you were disabled.
So, here is the problem: if the Social Security doctor says you are not disabled and your doctor does not believe in your disability, you may not have the evidence you need to prove your …
How to get your Social Security medical records – Part 5
In Colorado the cost of medical records are based on the number of pages you get. This means getting your records can quickly get expensive. But, you do not have to request every single scrap of paper, phone message, or referral that was ever generated by your doctor’s office. If you want to, you certainly can. But, chances are you will be paying for records you do not really need.
One way to keep the costs of your case down is to limit the scope of the medical records you are requesting. You can do this in two ways: Limit the dates of service (how far back …
What can I do if I cannot afford medical treatment on my Social Security disability case?
It is vital to get regular medical treatment when you are applying for Social Security disability benefits. I have even seen Judges roll their eyes when a claimant says there are no doctors they can see.
But, I don’t have insurance and I can’t afford to see a doctor on a regular basis. What am I supposed to do?
I’ve gone through my savings.
I’ve asked my spouse, parents and other family members to help me get medical care.
I’ve already even applied for Medicaid….
Social Security tip: get regular medical treatment
I hear a number of reasons for not seeing a doctor on a regular basis:
I don’t like going to the doctor.
I prefer herbal medicine.
I have a high threshold for pain.
When I hurt I just stay in bed.
This is unfortunate because regular and ongoing treatment is one of the foundations of building a Social Security case.
Why? Treatment generates medical records which do several things to build your disability case:
Medical records can establish a medically determinable impairment. Social Security regulations prevent approving a disability claim based on symptoms alone. Social Security requires a medically determinable impairment, basically, a diagnosis …
