Many disabled people and their loved ones express exhasperation with the catch-22 of the system that accepts or denies claims for Social Security Disability Insurance. To those who lack pre-existing health insurance, a comprehensive diagnosis with a physician’s statement might be difficult, or even impossible, to come by. This unfortunate reality prevents millions of Americans from receiving the SSDI payments to which they are fully entitled.
To prevent fraudulant claims from burdening the financial resources of the Social Security Administration, all SSDI and SSI claims are processed based on medical records– not patient statements. When filing a disability claim, a patient may report having migraines lasting ten hours per day– but, unless a doctor has confirmed that this is the case, signed a statement to this effect, and proven that the migraines persist even with months or years of treatment, the disabled patient’s own statements are irrelevant to the Social Security Administration’s approval process.
The rumor-mill of citizens without disabilities often includes stories of people who make fraudulant disability claims in order to scam the system because they simply have no desire to work. Conservative talk-shows and coffee shops are often filled to the brim with reports of people who receive Social Security Disability Insurance for conditions that either don’t exist, or are not truly disabling.
If there are any people who successfully receive Social Security Disability Insurance for non-disabling or non-existant conditions, they are very few and far between, especially compared to the horrific percentage– over eighty percent!– who are unfairly denied SSDI, even when they have fully lost their ability to work. Not surprisingly, those who lack pre-existing health insurance are at an especially high risk of facing rejection.
Uninsured patients are often forced by financial circumstances to simply go without medical care, even when it is critically important. A disabled person who lacks health insurance may have no records of medical care beyond an emergency-room treatment, and the same person is likely to become homeless if they can not return to work.
Even if the patient is terminally ill because of his disabling condition, he is likely to be rejected unless he can afford ongoing treatment for his symptoms– a daunting task for someone who has only weeks or months to live. Many patients die after years of illness, without seeing a single dime of the SSDI money to which they are entitled.
The Social Security Administration has created a supposed solution for uninsured people who are applying for Social Security Disability Insurance, but lack the medical records to substantiate a valid claim. When medical records are sparse or lacking, the state’s Disability Determination service will order the patient to see a doctor for a consultative exam. While the intended purpose of these examnations is, allegedly, to diagnose problems in people who are not receiving current medical care, the reality of the situation is quite different.
Doctors who perform consultative examinations almost never declare that a patient is disabled, even if the patient is unable to speak, walk, write, or maintain eye contact with the physician. When I took my husband for his “consultative exam”, he was examined while he was having a grand-mal seizure– thus, unable to cooperate in any way with the exam. Nevertheless, the physician declared “patient appears healthy” on his paperwork– and then offered to have him transferred to the local emergency room. A consultative exam physician is paid to say whatever the Social Security Administration wishes to hear.
For patients who are uninsured but facing profoundly disabling conditions, free and sliding-scale clinics can sometimes provide diagnosis or treatment to assist in a disability claim. However, without at least some record of ongoing and continuous medical treatment, the chances of winning a Social Security Disability Insurance claim are extremely slim. If you do not have health insurance but are unable to work, contact a Social Security attorney in your area. With his or her help, you may be able to secure the accurate diagnosis and medical treatment necessary for pursuing your claim.
Resources Used: Personal Experience, Interview with 10-year Disability Attorney