GAPS IN YOUR MEDICAL EVIDENCE

The medical record is the focus of every Social Security disability (SSDI) claim.  Decision makers will comb through your doctor's records to evaluate the severity of your symptoms.

Many times gaps appear in the treatment.  A claimant may stop seeing the doctor or stop taking medication.  This is often interpreted to mean that the medical condition has improved and that treatment is no longer necessary.  This implies that the claimant is no longer disabled.

Of course, there can be many reasons why an individual stops medical treatment:  financial reasons is the biggest one.  With no insurance and no income, it may be difficult to pay for doctors or medications.  If this is the case, the regulations say that Social Security can't hold lack of treatment against the claimant.  But the cause of non-treatment must be explained.

Gaps in the medical record actually cause two problems with Social Security claims:

1)  There is a failure to document the claimant's symptoms; and also there's a failure to determine how serious the condition would be if proper medical treatment had been followed.  "If you had proper treatment, you wouldn't be disabled," mentality.

2)  Failure to get consistent treatment may lead decision makers to assume that your condition just isn't all that severe or you would be going to the doctor.  I see denial letters all the time where the judge says something like, "Mr. Claimant alleges that he has frequent severe pain in his back and legs.  However, he has not had any medical treatment in over a year and is on no medication.  Therefore, I find his allegations of pain less than fully credible."

So, it's very important that your attorney or representative explain why you have discontinued medical treatment, or why you only see the doctor once a year.
__________
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
"Across from Bridge Street"
CALL US:  (256) 799-0297

SOCIAL SECURITY JUSTICE - OUR WEBSITE

E-Mail Me:   www.forsythefirm.com