A reader wrote in with this question: “Can I get SSD benefits without being under a doctor’s care? I am broke and have no money to see a doctor now that my insurance ran out.”
Like so many other legal issues, there’s not a simple yes or no answer to this question. The truth is, you’re unlikely to get disability without adequate paperwork from a doctor. The federal government needs to see clear evidence that proves your claim. However, there are ways to pursue disability benefits (and get medical evidence) even if you cannot afford a doctor’s care.
What Requirements Must I Satisfy for Disability Benefits?
The federal agency that oversees and grants disability payments is the Social Security Administration (SSA). The SSA requires that all disability applicants meet certain qualifications before awarding them benefits.
The first requirement is you must have a medical condition that meets the SSA’s strict definition of “disability.” It can be a physical injury, illness, mental health issue, or several different medical problems combined.
More specifically, your health issues must significantly limit your ability to perform basic work-related activities. Some examples include lifting, sitting, remembering, and standing 40 hours per week for a minimum of 12 months.
The SSA requires paperwork proving your health issues make you unable to work for one year. That paperwork will require that a doctor (or other acceptable medical source, in some cases) verifies your claim. If you aren’t currently under a doctor’s care for your issue(s), this may make it harder to get benefits.
What If I Can’t Afford A Doctor’s Care? Can I Still Get Disability Benefits?
Being under a doctor’s care helps when you are filing for disability benefits because the SSA requires convincing medical evidence. Failing to provide the required paperwork, or failing to prove your case, can result in being denied benefits.
But if you cannot afford a doctor’s care, there are things you can do to improve your odds of filing a successful disability benefits claim.
Prior Doctor’s Care, But None Recently: Will It Qualify for Disability Benefits?
If you cannot currently afford to be under a doctor’s care, you can gather any older records you have to submit to the SSA. Whether or not those previous records will be helpful for your claim depends on your current medical condition(s) and what your prior medical records can confirm.
For example, if you are filing for disability now due to ovarian cancer but your existing medical records mention a broken bone, those documents likely won’t help with for your SSD application. Why? Because the SSA only cares about medical records that apply strictly to the condition(s) listed on your claim.
In addition, the SSA relies on a team it calls “Disability Determination Services (DDS)” to determine who qualifies for benefits. While there are likely medical professionals on that team, DDS employees do not examine you themselves. They simply review the information you submit with your claim. So if you fail to submit any evidence (i.e., a doctor’s support), then they’ll likely deny you benefits.
Will a Consultative Exam Be Enough?
Unless your condition is one the SSA says clearly meets its definition of “disability,” the DDS team will ask you to undergo a consultative exam.
Th SSA sets up this evaluation for you with a Social Security doctor or medical professional of their choosing. The good news is that these exams are free (the SSA pays for them).
The downside is that appointments can be short. Someone who does not know you or your medical history will oversee your exam. They will look only for things as directed by the SSA. This means they are less likely to offer an exam as complete as one that you’d get under a private doctor’s care.
Can an Attorney Help Me If I Can’t Afford a Doctor’s Care?
If you cannot afford a doctor’s care, then you may not be able to pay the fees some offices charge for complete records. If that’s the case, sometimes an attorney can pay those fees on your behalf. Some states require doctors to provide copies of medical records for free if an attorney requests them.
In addition purchasing your medical records, an experienced attorney can help you understand the SSA’s policies and procedures. In fact, having an attorney file your claim can triple your chances of receiving benefits within six months.
Our attorneys work on contingency, so you pay nothing out of pocket for claim help. In fact, attorneys may only receive any payment for legal assistance after you win your case. If you don’t win, then you pay $0 to the attorney who helps you apply for disability.
Ready to see if you may qualify? Click the button below to sign up for a free, no-obligation phone call from a disability expert near you:
Lisa Allen is a writer and editor who lives in suburban Kansas City. She holds MFAs in Creative Nonfiction and Poetry, both from the Solstice Low-Residency Program in Creative Writing at Pine Manor College. Prior to becoming a writer, Lisa worked as a paralegal, where she specialized in real estate in and around Chicago.