Trajector Medical: Your Reassuring Partner in Navigating Medical Evidence for Your Disability Benefits Case

Receiving the disability benefits you’re entitled to can be challenging if you don’t provide comprehensive, well-organized medical evidence to the entity reviewing your case. This is true whether you’re applying for disability benefits with I Veterans Affairs (VA) or through Social Security Disability Insurance (SSDI), Supplementary Security Income (SSI), or private disability insurance. Without proper medical evidence, your disability benefits case can be denied.

For instance, using phrases like ‘feeling unwell’ instead of citing specific medical symptoms or indicating you’re ‘having trouble with daily activities’ instead of detailing the specific activities can leave gaps in your case, making it harder for decision-makers to assess your disability. Using precise medical terminology is essential for clarity.

Also, the medical data submitted should clearly demonstrate a disability and connect the ailment to your work limits or functional impairments. Additionally, differences in opinions among healthcare professionals might confuse those deciding a person’s case, potentially leading to a denial.

Potential Impact of Inadequate Medical Evidence

According to the National Organization of Social Security Claimants Representatives (NOSSCR), initial claims for disability with the Social Security Administration (SSA) were denied 61 percent of the time in 2023. At reconsideration, that number jumped to an 85 percent denial rate.

Many veterans receive a disability rating that does not accurately reflect the severity of their disability when filing for VA benefits because the medical data presented does not correctly or fully convey the impact of the disability.

Private insurers deny long-term disability (LTD) claims 50 percent to 70 percent of the time, citing improper or insufficient medical records and diagnostic test results.

Medical Evidence Required for Disability Claims

For SSDI and SSI

Under the two disability benefit programs (SSDI and SSI) administered by the Social Security Administration (SSA), people who file for disability benefits are responsible for providing medical evidence showing their impairment and its severity. The medical evidence should originate from what the SSA deems  “acceptable sources” who have treated or evaluated the person with a disability.

These ‘Acceptable sources’ include licensed physicians, psychologists, optometrists, podiatrists, audiologists, speech-language pathologists, and advanced practice registered nurses (APRNs). For example, a licensed physician who has been treating your condition over time can provide a detailed medical report that may carry significant weight in the disability benefits decision-making process.

When the SSA evaluates disability cases, they rely heavily on medical information from “treating sources.” These healthcare providers have an ongoing relationship with those applying for disability benefits. Treating sources are considered “acceptable medical sources” by the SSA and include doctors, specialists, or other healthcare professionals who have treated or evaluated the applicant over time.

Because these providers have a deeper understanding of the person’s medical condition and its progression, the SSA gives their medical evidence more weight in the decision-making process. This approach helps the SSA get a more comprehensive and accurate picture of the person’s health status and how it affects their life.

The medical reports submitted by healthcare professionals about an individual’s impairment should include medical history, clinical findings, laboratory findings (e.g., blood pressure, X-rays), diagnosis, treatment, prognosis, and a statement specifying what the applicant can still do despite the impairment based on the medical source’s findings.

For the VA

Disability cases filed with the VA require medical evidence that demonstrates the veteran has a chronic physical or mental disability. The evidence should also show that the disability is connected to the veteran’s active service. Moreover, the VA typically requires medical documentation such as a Nexus letter issued by a credentialed medical provider that shows a relationship, or “nexus,” between a veteran’s present medical condition and their military service to be considered for VA disability benefits.

For Private Insurers

When submitting a disability benefit case with a private insurance carrier, an applicant should provide proof of loss. This proof is based on thorough medical records, which serve as the foundation for the application process. An Attending Physician Statement (APS) is a required component of the disability benefits application process and should be completed by an applicant’s treating physician.

The statement includes a person’s diagnosis and restrictions due to their medical condition or conditions. Insurers typically also request functional capacity evaluations (FCEs), which assess the applicant’s physical and cognitive abilities to perform work, as key evidence in a disability case. They may also request authorization to obtain the applicant’s underlying treatment records to understand better the history and course of an illness and prognosis for improvement.

Discover Trajector’s Medical Evidence Services: A Beacon of Hope for Your Disability Case

Clear and precise medical documentation is critical to the success of any disability case. Well-organized medical documentation may increase approval rates, speed up processing times, and result in higher benefits.

If you are unsure about your documents, Trajector Medical’s licensed medical professionals, with their extensive expertise, are here to help. The company provides medical evidence services for people in support of their personal injury or government benefits cases. You only pay them if you receive an increased benefit due to their services.

Life-changing client experiences are central to everything Trajector Medical does. Its YouTube channel has more than 1,500 client video reviews from people the company assisted in compiling medical evidence to support their pursuit of disability benefits.