Social Security denied me disability benefits using a doctor of WHAT?
Social Security has physicians review disability cases as medical consultant’s to make opinions on individual’s abilities and limitations. However, what good is the medical consultant’s opinion if they don’t have expertise in with the disability in question.
Per Nate Craig:
… you may also want to look at the Medical Consultant’s Code attached to the State Agency’s opinion. I am finding more and more reviewing physician’s making opinions outside their professional field. Recently an ALJ relied on the State Agency’s opinion where the initial decision was made by a SDM and then affirmed by a “dermatologist” MCC of 6. The AC kicked it back with the directive for another physical CE. At the remand hearing, the same ALJ entered a decision of disability back to original onset date.
How to view Social Security’s new encrypted disks
I previously wrote about how to read Social Security’s (previously non-encrypted) cd disks and several articles on how to find information with the Social Security files.
Since Social Security has started provided encrypted Social Security exhibit CDs, many people contacting my office have not been able to access their files. The Social Security encrypted disks are keeping claimants from accessing their data.
First, you have to be running Microsoft Windows. Fortunately, some early concerns about having the encryption system only working in Windows Vista seem to be unfounded. I have been able to access the encryption system in Windows 7. However, if you are using a Mac (like I am) or Linux, you are out of luck unless you virtualize a Windows system.
Let’s go through how to get at those file!
Getting your prior Social Security files
If you are looking at your Social Security exhibit file and you notice that all the exhibits are numbered with a letter in front, such as “B1A, B2A, B1B, B2B,” etc, this means that you are looking at the “B” file — a file for the second application for Social Security disability benefits.
In other words, the first time you file for benefits, Social Security creates an “A” file. Since this may be the only file you ever have, it is not referred to as the “A” file. However, if you file a second application, the second file becomes the “B” file. The …
Reviewing your Social Security exhibit file – Part 3 work history
Now that I know the critical dates and the medical history I review the work history. Social Security reviews cases using the 5 step sequential evaluation process. At step 4, if you are still able to do any of the jobs you performed in the last 15 years before you became disabled, you can be denied benefits. There are a couple more wrinkles to this, such as the job has to be a substantial gainful activity, but the general idea is that if you can still do a …
Reviewing your Social Security exhibit file – Part 2 Critical Dates
What’s the next thing to review in the Social Security exhibit file after the medical records? Check these critical dates: Alleged Onset Date (AOD) & Date Last Insured (DLI)!
The E section usually contains for two documents that provide this information:
“Disability Report – Field Office”
“Disability Report – Appeal”
These reports also tells you whether Social Security thinks there should be a later (or earlier) alleged onset date and Social Security also discussed whether work after the alleged onset …
My Social Security file is missing records
Let’s say you are reviewing your Social Security exhibit file before your disability hearing and you discover that some of your doctor’s (or other records) are not there. I have mentioned before that it is not unusual for the medical records in a Social Security file to be a year or more out of date.
What can you do if the records are not complete?
You can ask Social Security to update the records. If you do not have a lawyer Social Security has a higher responsibility to make sure that your hearing is fair, which includes …
Reviewing your Social Security exhibit file – Part 1: Medical Records
How do you begin to review your Social Security exhibit file? Here is a quick guide to finding the really important parts.
Start with the “F” section to review the medical records.
If you do not review anything else in the file, you need to know what medical records are there (and what records are missing).
Here is what I look for:
Are all the doctors and hospitals listed? If the doctor or hospital is not listed, …
What is in a Social Security file?
Just before your Social Security hearing, you will be given a cd and pointed at a computer. If you ask, someone may help you load up the disk and get you to a screen that looks like this:
Ok, now what?
What is all this stuff and what do I do with it?
Social Security uses electronic case files. The image above is the “Exhibit List Index” which may automatically come up when you insert the disk into the computer (if it does not, you may have to browse to your cd and double click “index.html” If in doubt, just ask your kids.
The Exhibit List Index is a “table of contents” for the documents in the file.
In the above image, you can see there are 4 exhibits in the “B” part of the file. The first one, 1B is a request for hearing and that document is 5 pages long. By clicking on any link (blue underlined text) you will be taken to that exhibit.
I know how to move around in the exhibit file, but I don’t know what I am looking at!
Ok. The file is divided into different sections, labeled A through F. Here is what you can find inside each section.
Don’t go to your Social Security disability hearing with out-of-date medical records!
It surprises my clients to learn that, most of the time, Social Security does not update medical records after the initial denial.
With wait times of a year or more, this can mean that by the time your case gets in front of a judge, the records in your file may be a year (or more) old, and your recent treatment may not be in the file at all.
This is not the way the system is supposed to work.
How to review your Social Security file before your hearing
My last article talked about why it is so important to review your Social Security exhibit file.
But how do I get a copy of my Social Security file?
If you already have a hearing scheduled, Social Security will tell you in the Notice of Hearing that you should arrive thirty minutes before your hearing and you will then have a chance to review your file.
However, 30 minutes is NOT enough time to review your file. If you are like most people, you have never seen a Social Security file. If you simply start at the beginning of your file, your case may be called before you even get to your medical records.
What does Social Security really think about your case?
Wouldn’t you like to know what Social Security really thinks about your claim? The best way to find out is to review your Social Security exhibit file.
Everything Social Security has on your claim for disability benefits is contained in the “exhibit file.” This includes medical records, statements of limitations, notes from Social Security’s technicians, reports from any doctors Social Security sent you to, and any opinions Social Security based on the evidence in your file. Plus, you may even see post it notes flagging what Social Security thought was particularly important.
“But, wait there’s more…” The exhibit file also contains income summaries and earnings reports, as well as every form you filled out during your application, and possibly your prior files as well.
Why is this important?
If you want to know why you were denied (something more substantial than what Social Security told you in their denial), and what your chances are at hearing, you need to review your Social Security file.
