Category Archives: Obamacare

Having Appropriate Treatment for Your Medical Conditions is Crucial for Your Case! SSD in a Nutshell Series Blog 4

Seems like an obvious statement, right?  Well surprisingly there are many Social Security Disability claimants who are not receiving sufficient treatment for their conditions.  Not only does a person benefit by having sufficient health treatment for his medical conditions but his disability case will also benefit.

Until very canstockphoto0076124recently, it was nearly impossible for someone without medical coverage to get appropriate medical treatment. If health insurance was not offered through a person’s employer it was very likely he could not afford to purchase private medical insurance.  The new system is still very far from perfect, but it is somewhat easier these days to receive affordable medical treatment.  I still see about 30% of clients that are still without coverage and adequate treatment.  This is too often out of the control of the client.

Social Security (SSA) is not supposed to deny someone disability benefits for lack of medical treatment.  SSA can send the claimant for examinations.  A good disability advocate that is will assist his client in finding medical care to address the medical conditions the client suffers. The advocate can help the client work with her insurance provider to find a physician or to locate community healthcare for little or no cost. One does not want to rely solely on SSA to schedule an examination to determine disability if it can be helped.

SSA examinations are often a one-time event where where the disabled person is very quickly examined by a physician who knows little or nothing about the medical history of the person.  Some of these physicians do not specialize in the particular condition the person suffers. As mentioned in previous blogs, many of these physicians perform at the highest of medical and professional standards.  Not all of them do. Some do not submit accurate reports of the claimant’s conditions, unfortunately. Perhaps these physicians believe they will no longer get business from SSA if the confirm a person’s disabling conditions. Some of these physicians lack the ability to properly examine the claimant or simply do not thoroughly examine the claimant. Sadly, these bad exam reports can be used against the claimant..  Sometimes the reports are supportive of approving a case and somehow a a wrongly creative SSA decision maker finds a way to disregard the supporting information. It is always best to have the disabled claimant’s own physicians opinions on the record.

Consideration must be given to the opinions of the claimant’s own physician. Sometimes SSA will still require an additional exam from one of its physicians.  Yet, having one’s own physician providing records of treatment, diagnoses, prognosis, tests, etc., is always a benefit to a claim.

who is contemplating or actively pursuing disability should make she she communicates ALL her conditions and impairments to her doctors. A common issue I have come across is a person who has significant pain or other issues that clearly contribute to her disabilities and she does not inform her doctor. A person should always make sure her physicians are noting her health concerns and whenever possible assisting the person with consulting with specialists when needed.  Keeping record of medication side effects, seizures, headaches, days where one cannot get around well due to pain, etc., are a great way to keep the physician informed. The doctor is likely to note these things and this will be reflected on the disability case record. Always ask for a written prescription for canes and other assistive devices. If the doctor tells a person she needs a cane of course she should obtain and use one.  For all sorts of reasons the person should request a written prescription.  One would be in getting assistance from the insurance company paying for these items.  The other is prove to SSA that a cane or other device is needed.  A case can turn on something seemingly as simple as a doctor documenting his patient requires a cane.

If a person is having difficulty getting healthcare treatment and he has no insurance effort must be made to get him established for care with his own physician. Some resources and information can be found at:

Medicaid Website

It may also be helpful to search the web for low-cost medical treatment in the area the claimant resides. There is often lag time before Medicaid or insurance coverage will begin, and sometimes coverage under either is unavailable for the claimant. Seeking treatment at a free clinic may be a great way to establish care.


Feel free to comment or ask questions!

©2016 April L. Roberts and Aaria Consulting, LLC. All Rights Reserved.

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