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How Gaps In Your Medical Care Affect Your Social Security Disability Claim

When you're sick, you're supposed to go to the doctor, right? That's pretty much the logic the Social Security Administration uses when it is evaluating disability applications. There's an inherent presumption that anyone suffering from a severe, chronic condition would just naturally keep getting help for that condition.

Except that isn't always how things work. For one reason or another, many people who have disabling conditions go without medical treatment. Here's why that's a problem if you file for disability benefits and what you can do about it.

1. Why are gaps in your medical care a problem?

The Social Security Administration (SSA) needs to use your medical records in order to establish whether you meet the requirements for the disability benefits they manage. If you haven't seen a doctor for a while, then your medical information may be too old to use and not even really reflective of how severe your condition is today. If there's a gap in your care and you suddenly picked up your care again just before you filed, it may seem suspicious to reviewers that you became suddenly much worse.

2. How can you explain why you haven't sought medical care recently?

In order to make it clear that you haven't somehow gotten better, you want to explain to SSA why you stopped treatment. Here are some of the most common reasons people quit going to a doctor:

  • No further improvement was possible. If your doctor or physical therapist told you that you had reached the maximum level of improvement for your condition, then there was no point in continuing.
  • You had already tried every possible treatment. You took every drug, went through ever therapy, and had every test. Your doctor has no further idea of what to try.
  • You didn't have insurance. This is a common issue for people who are struggling financially because of their disability or who have periods of unemployment.
  • You were suffering from a mental impairment. Maybe your condition left you so depressed that you couldn't muster the energy to keep going to the doctor's office.

3. What else can you do to make it easier to handle this issue?

The more organized your medical records are when they go to SSA for evaluation, the more likely you'll be approved. A Social Security attorney understands what SSA needs to see in order to approve your claim. Your attorney can organize your records — and explanations for any gaps — in a way that makes the timeline and progression of your disability make sense. 

If you're struggling with a disability application, talk to a Social Security attorney today.