Documents Needed to Prove
Disability to Social Security
As you become more familiar with the disability application process, you will see repeated references to a “Social Security disability claims file” or, as it is sometimes called, your “exhibit file.”
What Exactly is This Claims File
and How do You Update It?
Stated simply, your claim file contains all of the documents submitted by you or collected by Social Security personnel about your case. Your actual file is a yellow cardboard multi-part file. Documents are added to the file by hole punch on the left side. Each section is identified by letter - i.e., the A section, the B section and so forth. The F section contains the medical records related to your case.
Who is the “Adjudicator?”
When your case is first opened, it is assigned to a claims examiner called an “adjudicator,” whose job is to request medical and vocational information. This is why it is so important for you, as the claimant, to provide Social Security with a detailed and accurate list - including names, addresses and phone numbers - of physicians, hospitals and other health care providers.
As your case progresses through the system, your case file - that yellow cardboard file - is passed from office to office, and from person to person. Eventually, if your case is denied at the administrative level, it will end up in the hands of an administrative law judge, who will rely on the information in your file to make a decision in your case.
The Future - Electronic Claim Files
Social Security is currently attempting to replace this manual system with an electronic file system that relies on scanned documents. Needless to say, the process of moving from manual files to electronic files is going to be a slow and deliberate process. Social Security is concerned about the privacy of your medical and vocational information and it is slowly developing policies designed to both use and safeguard your personal information.
Adding Documents to Your File
Although your Social Security case is a legal proceeding, the rules of evidence are greatly relaxed when it comes to submitting evidence. Social Security will accept documents, letters and forms from you without any special certification.
After you file your initial application, you will begin to receive letters from the disability adjudicator working your case (in most States, SSA contracts with State personnel to develop your file). The letter will contain the name and address of the claims agent (disability adjudicator) responsible for your file.
Your Goal - A Complete Claims File
Your goal as the claimant is to make sure that your claims agent has all available medical and vocational data so that she can evaluate your claim. Unfortunately, Social Security sometimes loses documents, so it is clearly in your best interest to make a copy of anything you mail in to your claims rep and to collect your own file of medical records.
W hen you file your claim, you will be asked to sign a number of blank medical authorization forms. You can also download this form, called the SSA 827, here. In general, you should include two or three of these signed authorization forms whenever you submit any document to Social Security.
The documents that Social Security uses to decide your claim include:
- medical records from doctors, hospitals and medical providers who have examined or treated you. This includes the reports from doctors or psychologists who have examined you at the request of Social Security. Note that doctors are trained to keep records about every patient they see, even if it is a one-time visit for 10 minutes
- statements from friends, co-workers and relatives
- claim application documents, including your initial application, your appeals, and SSA’s denials or other responses
- evaluations by physicians and psychologists who have not met you personally but who have evaluated the medical records in your file and issued written reports for the claims rep
- anything else you may have sent in
In some areas, your claims rep will advise you in writing if she is having difficulty obtaining medical records. In busier jurisdictions, you will not discover that medical records are missing until you receive a denial notice.
Although you do not want to overburden your claims rep with duplicate paper, there is nothing wrong with submitting copies of medical records that you may have in your possession. A sample submission letter is here.
W hile Social Security personnel are required to develop your file, you should take an active role in confirming that all relevant medical records have reached your file.
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