Abromson & Carey, Attorneys at Law
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How is medical information submitted for SSD benefits?

New Jersey's Division of Disability Determination Services determines whether a claimant meets the definition of disability to receive Social Security disability benefits. Under the law, a claimant must meet medical requirements for SSD benefits eligibility.

Health care providers may submit medial information through its electronic records express. A medical report should contain symptoms, signs and laboratory findings that demonstrates that the patient has a medically determinable impairment that is sufficiently severe to prevent the applicant from working for at least one year.

The medical evidence and its clinical and laboratory findings should be complete and detailed so that the SSA can make its eligibility determination. The report should allow the agency to determine the impairments nature and limiting effects, its possible length and the claimant's ability to take part in physical or mental activities related to work.

A medical consultant and claims adjudicator team performs a paper review of these reports with no contact with the claimant. If additional information is needed, the team will contact the claimant's physician.

Normally, this report is sufficient for the Social Security Administration to make its disability determination. The health care provider usually has a long-term relationship with the claimant, so the know the extent of the claimant's disability and the claimant's response to treatment.

However, an independent medical evaluation may be requested by the Division of Disability Determination Services if there is insufficient or outdated medical evidence. Licensed medical doctors, osteopathic physicians or licensed or certified psychologists may perform these consultative examinations.

The consultative examiner reports clinical findings based upon signs, symptoms and laboratory results and does not make a recommendation on whether the claimant is disabled. If a claimant is dissatisfied with the quality or professionalism of this examination, their physician may report the complaint to the Professional Relations Unit.

A claimant undergoing this process must present sufficient information to meet federal regulations. A lawyer may assist claimants present this medical evidence and appeal denials.

Source: New Jersey Department of Labor and Workforce Development, "Social Security Disability Programs FAQ," Accessed April 18, 2017

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