Essential Documents for a Strong SSDI Claim in California

According to the Social Security Administration, it denies benefits to about 62% of the individuals applying for Social Security Disability Insurance benefits. A lack of SSDI supporting evidence is a common reason for the high rate of denied claims.

When an initial application is denied for insufficient disability claim documentation California residents can gather the evidence and present it during an appeal. Sackett and Associates wants you to be aware of the evidence and documentation required for a successful SSDI application or appeal. Here is an explanation of the documents and evidence required for a strong SSDI claim in California.

SSDI program and proving entitlement to benefits

You cannot be approved for SSDI benefits without meeting both work and disability requirements. The SSDI program is part of the Social Security system, so you must have worked and paid into the system through Social Security payroll taxes.

The work history has to be long enough to meet SSDI guidelines. Social Security uses work credits to gauge the duration of your work history. Workers earn credits based on their annual earnings up to a maximum of four work credits per year.

A disability, according to the federal definition used by the Social Security Administration to evaluate applications for SSDI, requires that a person have a medically determinable physical or mental impairment expected to result in death or expected to last for at least 12 months. The impairment or impairments must keep the person from doing any substantial gainful work activity.

“Medically determinable” means an impairment proven with “objective medical evidence,” which federal regulations define as observable physical or mental abnormalities that can be identified apart from a claimant’s statements using clinical diagnostic techniques, including blood tests, imaging, and psychological testing.

Gathering documents to apply for SSDI

Mistakes, omissions, and inconsistencies in an application may result in processing delays and even a denial of a disability benefits claim. The gathering of documents needed for SSDI claim application preparation should begin as soon as you decide to apply for disability benefits.

The Social Security Administration may require proof of some of the information contained in an initial application for benefits, including:

1. A birth certificate or other form of proof of birth.
2. Passport or other proof of U.S. citizenship or lawful alien status.
3. W-2 forms or prior year’s self-employment income tax return.
4. Adult Disability Report containing information about work history and medical conditions.
5. Medical evidence that a claimant has in their possession, such as test results.
6. Award notification of workers’ compensation, short-term disability benefits, or other forms of public benefit payments received by an applicant.

Having the documents available when filling out an application helps to ensure accuracy and provides the information you’ll need to avoid leaving blanks or guessing.

Medical evidence to prove an SSDI claim in California

A diagnosis alone, without anything other than a patient’s statements, would not be sufficient to prove the existence of a physical or mental impairment. To prove that a person has a disability that meets federal standards requires SSDI medical evidence California Social Security claims examiners can review, including the following:

1. Physical examination findings, including medical history, diagnosis, and physicians’ notes.
2. Laboratory test results, such as blood and other types of specialized testing.
3. Diagnostic imaging reports, including X-rays, MRIs, CT scans, and other imaging based on medical condition.
4. Reports and evaluations of specialists based on the specific medical condition.
5. Detailed treatment plan, including prescribed and other forms of treatment depending on the nature of the condition.
6. Statements from treating healthcare professionals about the limitations imposed by the medical condition on a patient’s ability to do day-to-day tasks and work activities.
7. Hospital records detailing the number and lengths of inpatient treatment, emergency department visits, and surgical procedures performed.

Medical records should include a prognosis supported by evidence of the patient following treatment recommendations and taking prescribed medications as directed. The prognosis should include an indication of any improvement in the patient’s condition.

Although technically not medical evidence, a journal kept by the claimant can be used to supplement the medical evidence to prove the impact of a medical condition on the individual’s daily life. A journal or diary should include daily, dated entries of the following:

1. Symptoms, including date and time, along with severity and duration.
2. Things or situations that cause symptoms to occur. For example, a person claiming benefits for migraine headaches should note triggers that cause symptoms.
3. Dates and times that you take prescribed medications, including side effects and whether they make your condition better or worse.
4. Limitations you experience in your daily activities and those activities related to working.

The more SSDI medical records CA residents have to support their disability benefits claim, the better their chances of approval.

Contact A Disability Attorney for Assistance.

For more than 45 years, the disability benefits professionals at Sackett and Associates have helped individuals throughout Northern California and nationwide gather the evidence needed for a strong SSDI claim. Contact Sackett Law today for a free consultation and case evaluation.