About half of all adults in the U.S. report difficulties affording healthcare costs, and nearly 30 million Americans remain uninsured. The inability to afford medical treatment can pose a serious problem for those seeking disability benefits with Social Security Administration, as the burden of proof is on the claimants to prove they have a disability which prevents them from performing substantial gainful activity. When an individual can no longer work due to a disability or otherwise, they often can no longer afford health insurance either. Without medical treatment, there is often a dearth of evidence to support a disability claim.
For the initial determination, the Social Security Administration will attempt to acquire medical records from your treating providers, typically going back a year before the onset date. The agency may also send you for a consultative examination with an independent medical practitioner, though the treating provider is the preferred source of evidence. As the consultative examination is for an evaluation of disability only, not for treatment, it is often not as helpful.
Most claims are denied at the initial application and reconsideration. The claimant may then be waiting months or even years for a hearing before an administrative law judge, where they are statistically more likely to be approved. During the interim period, claimants are expected to continue seeking medical treatment and will have the opportunity to submit additional evidence of disability at a hearing. If an individual is unable to afford ongoing medical treatment with their own provider due to lapsed insurance, the claimant should document attempts to obtain free or subsidized insurance as well as healthcare from a free clinic or other community resource. The claimant may also want to consult with an attorney specializing in disability claims in order to maximize presentation of the available evidence.