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Fight For Your Rights. Secure Income. Restore Dignity.
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The importance of evidence in an SSDI claim

On Behalf of | Oct 12, 2021 | Social Security Disability Insurance

For Illinois residents who have suffered an injury, condition or illness that renders them unable to work, Social Security Disability Insurance (SSDI) is a viable option. Filing the application and getting the benefits can seem challenging, but it is imperative to follow the process as the Social Security Administration (SSA) requires and to provide all necessary information and – most important – medical evidence of disabling impairments. Since missteps and mistakes are frequent catalysts for denied claims and delay the process, it is essential for applicants to be cognizant of the evidentiary requirements.

Understanding what evidence is needed in an SSDI case

When applying for SSDI, there must be medical evidence to show impairments exist and are of sufficient severity to preclude competitive work. Medical sources who evaluate, examine and treat are critical, as are all other treating entities like clinics, hospitals, and physical and mental health therapists. The evidence must show that the applicant is impaired and the provider must be credible – which means their opinion is consistent with their records.

A disabling impairment must be so problematic that it prevents or inhibits a person’s ability to function at work. There are basic requirements at most jobs – even the most sedentary types of work – and if a person cannot perform these functions which includes standing, walking, sitting, reading, exercising appropriate judgment and social skills, and  completing basic tasks, it should be apparent in the medical evidence. SSA must have enough information to determine how severe an impairment is, how long a claimant has had it, and if the claimant can perform work, both mentally and physically.

There are times when the medical sources from the claimant are deemed insufficient for the SSA to make its determination. Applicants must be prepared to take part in a consultative examination (CE). The applicant’s medical source can perform a CE, but it is possible – and common – that an independent medical professional paid by SSA will be asked to assess the claimant. This could be due to the claimant’s own physician not being available (or asked) to perform the CE, or the treating physician not having the equipment needed to do it; conflicting information; or SSA’s concerns about the original source of evidence.

Regarding symptoms, the SSA will want to know if the applicant has pain, is short of breath, grows fatigued or has other issues that inhibit the ability to function. Details about the extent of activities a person can perform, pain, what can exacerbate symptoms, medications/side effect, and courses of treatment are also crucial to the case.

Gathering appropriate evidence is vital for a successful SSDI claim

There are some cases in which the medical evidence simply proves what is obvious. If the applicant is unable to move a limb, it is easier to show that the benefits are warranted than it would be for someone who has a soft-tissue back injury. It is important to remember that eac case is different and will be decided on its own merits. The evidence is a major part of that. Making certain that it is provided as the SSA requires is a pathway to getting approved for SSDI. As with any aspect of a claim for benefits, having professional assistance can be the key to a successful outcome. Consulting with those experienced in SSDI claims is a wise first step and should be understood from the start to avoid unnecessary delays and unexpected denials.