Tuesday, March 23, 2010

Regular Treatment is a MUST!

One of the basic things that can lead to denial of a claim is failure to see a physician on a regular basis. Administrative Law Judges use this as a basis for Denying claims all the time. So while you are going through the process of getting denied benefits, appealing, probably getting denied again, requesting a hearing, and waiting for your hearing (the official wait time in Sacramento, CA from the date you file for your hearing is over one year, actually 405 days and the entire wait from the time you originally file your application can easily be 2 or more years), it is mandatory that you are receiving regular treatment.

I like a client to see the same physician on a monthly basis. Avoid gaps in treatment! If you also have a mental impairment (depression, anxiety, etc.) that contributes to or is the primary basis for your disability, regular treatment with a psychologist or psychiatrist is extremely helpful in getting your claim approved. The reality is that many Judges look at the failure to get regular treatment as evidence that your problems are not as severe as you say they are. Same with the failure to see a psychiatrist or psychologist.

Also, in general, the Administrative Law Judge will give more weight to the opinion of a medical doctor (M.D.) than to a nurse practitioner, physician's assistant or chiropractor. So wherever possible see the M.D.! On the issue of how limiting your mental impairments are, the ALJ will give more weight to psychiatrists (M.D.) or psychologists (Ph.D.) than to counselors or social workers.

What I've stated above is very general, but the point is that you need to have sufficient evidence to back up your claim. Start getting the regular treatment as soon as possible, or you run the risk of being flat out denied or at a minimum losing out on past due benefits.

Obviously, there are situations where people are unable to see a Medical Doctor or psychiatrist, maybe due to the type of insurance or lack of insurance, but these situations should definitely be addressed with an attorney early on after filing your claim. Call me for a free consult, and we can figure out what needs to happen to get you approved! 1-800-404-4458.


HADLEY & FRAULOB SOCIAL SECURITY & SSI ATTORNEY

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