The process of filing a Social Security disability claim can be confusing and frustrating. The Social Security Administration website and representatives can offer some basic information, but they aren’t able to provide financial, legal, or medical advice. So, one question many people ask about the process is: Do you need medical advice to get on Social Security?
Understanding how medical advice fits into the Social Security process can make a real difference in avoiding delays and denials in the process. However, if you need legal advice about a specific case, you need to speak with a trusted Social Security attorney to review your situation and help you determine your options.
Medical Advice and Disability Claims
Social Security disability insurance is a government-run program that provides income for eligible individuals who qualify. One of the main requirements is that the person applying has to have medical evidence of an impairment that is severe enough that they are not able to work. This medical evidence has to come from an acceptable medical source. In short, medical advice is not only necessary but an essential part of the Social Security process.
Understanding when to submit updated records, what records to submit, and how to address treatment gaps helps you prevent avoidable denials. Ways to show whether limitations have persisted over time and prove your conditions are still present include:
- Follow-up visits
- Updated testing
- Consistent documentation
- Records that describe functional limitations, not just diagnoses
- Consistency across providers
- Statements that reflect day-to-day limitations accurately
Social Security Eligibility
Medical documentation plays a central role in disability claims because Social Security serves an enormous number of people nationwide. The program supports approximately 66 million beneficiaries, including retirees, disabled workers, and survivors, according to a recent report.
The annual cost of Social Security is projected at 5.3% of Gross Domestic Product (GDP) in 2025, according to the National Committee to Preserve Social Security and Medicare.
Because of this scale, medical evidence is reviewed within a tightly regulated system, and claims are routinely denied when records fail to clearly show how conditions limit basic work activities.
Doctors provide medical findings and opinions, and the Social Security Administration (SSA) applies legal eligibility standards, which also include non-medical eligibility requirements, such as work credit hours, which doctors generally do not play a role in. Non-medical factors can still block approval. Common non-medical factors the SSA looks for include age, income, past work and transferable skills, and ability to adjust to other work.
Why You Should Hire a Social Security Lawyer
When filing for benefits, it is important to understand that the timing of your medical records and doctor follow-up is just as important as providing your records. If your medical evidence doesn’t match the period being reviewed, outdated records might carry less weight. Any appearance of gaps in treatment can create an impression that symptoms have improved and could prevent you from receiving your benefits.
Common Medical Documentation Mistakes That Delay Benefits
When you coordinate your medical care with the claims process, it ensures that your medical records reflect any limitations you currently have. If you have any concerns about gaps in your records or issues regarding your claim, hire a Social Security lawyer who can help you navigate the process and receive the benefits you deserve.
FAQs
Q: Can a Doctor Approve a Social Security Disability Claim?
A: A doctor can’t approve a Social Security disability claim. Only the SSA can approve claims. A doctor does need to provide the SSA with accurate medical evidence that shows the patient is unable to work due to the limitations of their disability, which is one of the key requirements for eligibility when it comes to SSDI.
Q: Can Social Security Make You Get a Medical Exam?
A: Yes, Social Security can make you get a medical exam. This is called a consultative examination (CE), and it may be required if the medical records you provide do not provide medical evidence that is sufficient for the SSA to make a determination. These exams are generally paid for by the SSA, and not attending the exam when it has been requested can lead to a denial or suspension of benefits.
Q: What Kind of Information Needs to Be in a Medical Report for SSDI?
A: A medical report for SSDI needs to include the as much relevant medical history of the patient’s disability as possible, such as the medical history, clinical findings, laboratory or imaging tests, diagnosis and prescribed treatment, response to the treatment, and the doctor’s medical opinion of how this relates to the patient’s ability to work, including a statement of what work activities the patient is still capable of, even with the disability.
Q: Can You Get on Social Security Without a Doctor?
A: You can get certain benefits from the Social Security Administration without a doctor, such as Supplemental Social Income (SSI), which is based on need and income rather than medical records. However, in most cases, you are unlikely to get approved for Social Security disability benefits without extensive medical documentation that proves your disability prevents you from being able to work.
Q: What Should You Not Say to a Social Security Doctor?
A: There are many things you should not say to a Social Security doctor, but it is especially recommended to avoid minimizing your symptoms or overstating your abilities during exams. Inconsistent statements can weaken your credibility and negatively affect your claim. Casual remarks about daily activities, improvement, or work abilities may be misinterpreted and used to reduce the perceived severity of your condition.
Contact Gade & Parekh, LLP Today
Gade & Parekh, LLP is a Sacramento Social Security law firm dedicated exclusively to Social Security Disability and SSI representation. Our attorneys draw on more than three decades of Social Security Disability experience, including appellate-level advocacy. We serve clients throughout Sacramento County with focused legal advocacy and detailed case review.
If questions about medical evidence or eligibility are affecting your claim, contact Gade & Parekh, LLP today.