If you have decided to apply for social security disability benefits, you likely already understand how important your medical records are to the review process. However, what you might not know is what it means if there's a gap in your medical care. No matter the reason for why you stopped seeing a doctor, that care gap is going to be an important factor in your benefits decision. Here's a look at what you need to know about medical care gaps and your disability application.
Can A Gap In Care Lead To A Denial?
A gap in your medical care can, in fact, lead to having your benefits application denied. When the reviewer sees that gap in coverage, he or she may assume that you stopped going to the doctor because your symptoms improved. In that type of situation, it would be determined that you don't qualify for disability benefits because you no longer need medical care since your symptoms have gotten better.
What If You Didn't Stop Because Of Improvement?
If you had another reason for stopping your medical treatment, you may still be able to qualify for disability benefits. However, you'll need that reason clearly documented in your medical records, so you'll want to be sure that you talk to your doctor about it ahead of time. There are several different reasons why you might stop your medical care, and some of them will not affect your disability determination.
How Can You Still Qualify Despite Stopping Your Medical Care?
If it is properly documented in your medical records, there are actually a couple of things that can explain ceasing medical treatment without actually being able to return to work. For example, if you are financially unable to afford the medical care and your insurance isn't covering appointments, this doesn't reflect on your condition, so it may not affect the final decision.
You might also stop treatment because the doctor is recommending that you undergo surgery for your condition and you are apprehensive. If you're not sure that surgery is the right path, or you're afraid of complications, this can be a reason to stop medical care, even temporarily.
If you've reached a point where you are not going to physically improve any further, even with a doctor's intervention, you may decide that it's time to stop going. This is a situation that is referred to as maximum improvement, and you won't typically be penalized for stopping care at this point either, but your doctor needs to illustrate that in your record.
Make sure to consult with social security insurance services to learn more.